St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

AFTERCARE, OPEN WOUNDS AND OTHER TRAUMATIC INJURIES

Facility

$199.03

Service Code	EAPG 00585
Min. Negotiated Rate	$199.03
Max. Negotiated Rate	$199.03
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$199.03

AFTEREFFECTS OF CEREBROVASCULAR ACCIDENT

Facility

$218.55

Service Code	EAPG 00533
Min. Negotiated Rate	$159.69
Max. Negotiated Rate	$218.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$159.69
Rate for Payer: Healthfirst Commercial	$218.55

AICD AND RELATED CARDIAC DEVICE INSERTION OR REPLACEMENT

Facility

$26,261.88

Service Code	EAPG 00097
Min. Negotiated Rate	$19,062.89
Max. Negotiated Rate	$26,261.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,062.89
Rate for Payer: Healthfirst Commercial	$26,261.88

AIDS

Facility

$291.38

Service Code	EAPG 00881
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$291.38
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$210.60
Rate for Payer: Healthfirst Commercial	$291.38

ALBENDAZOLE 200 MG PO TABS

Facility

$228.91

Service Code	NDC 4279911002
Hospital Charge Code	4279911002
Hospital Revenue Code	250
Min. Negotiated Rate	$80.12
Max. Negotiated Rate	$183.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.45
Rate for Payer: Aetna Government	$114.45
Rate for Payer: Brighton Health Commercial	$171.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$183.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.66
Rate for Payer: EmblemHealth Commercial	$114.45
Rate for Payer: Group Health Inc Commercial	$114.45
Rate for Payer: Group Health Inc Medicare	$80.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.45
Rate for Payer: Hamaspik Choice Inc Medicare	$114.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.79

ALBENDAZOLE 200 MG PO TABS

Facility

$228.91

Service Code	NDC 7220505108
Hospital Charge Code	7220505108
Hospital Revenue Code	250
Min. Negotiated Rate	$80.12
Max. Negotiated Rate	$183.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.45
Rate for Payer: Aetna Government	$114.45
Rate for Payer: Brighton Health Commercial	$171.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$183.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.66
Rate for Payer: EmblemHealth Commercial	$114.45
Rate for Payer: Group Health Inc Commercial	$114.45
Rate for Payer: Group Health Inc Medicare	$80.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.45
Rate for Payer: Hamaspik Choice Inc Medicare	$114.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.79

ALBENDAZOLE 200 MG PO TABS

Facility

$228.91

Service Code	NDC 4279911002
Hospital Charge Code	4279911002
Hospital Revenue Code	250
Min. Negotiated Rate	$114.45
Max. Negotiated Rate	$114.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.45

ALBENDAZOLE 200 MG PO TABS

Facility

$228.91

Service Code	NDC 7220505108
Hospital Charge Code	7220505108
Hospital Revenue Code	250
Min. Negotiated Rate	$114.45
Max. Negotiated Rate	$114.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.45

ALBENDAZOLE 200 MG PO TABS

Facility

$261.80

Service Code	NDC 3172293502
Hospital Charge Code	3172293502
Hospital Revenue Code	250
Min. Negotiated Rate	$130.90
Max. Negotiated Rate	$130.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.90

ALBENDAZOLE 200 MG PO TABS

Facility

$261.80

Service Code	NDC 3172293502
Hospital Charge Code	3172293502
Hospital Revenue Code	250
Min. Negotiated Rate	$91.63
Max. Negotiated Rate	$209.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.90
Rate for Payer: Aetna Government	$130.90
Rate for Payer: Brighton Health Commercial	$196.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$209.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$178.02
Rate for Payer: EmblemHealth Commercial	$130.90
Rate for Payer: Group Health Inc Commercial	$130.90
Rate for Payer: Group Health Inc Medicare	$91.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.90
Rate for Payer: Hamaspik Choice Inc Medicare	$130.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.17

ALBUMIN HUMAN 25 % IV SOLN

Facility

$1.39

Service Code	HCPCS P9074
Hospital Charge Code	0944049303
Hospital Revenue Code	258
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$0.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.69

ALBUMIN HUMAN 25 % IV SOLN

Facility

$1.12

Service Code	HCPCS P9074
Hospital Charge Code	6851652161
Hospital Revenue Code	258
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56

ALBUMIN HUMAN 25 % IV SOLN

Facility

$1.39

Service Code	HCPCS P9074
Hospital Charge Code	0944049301
Hospital Revenue Code	258
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$1.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.69
Rate for Payer: Aetna Government	$0.69
Rate for Payer: Brighton Health Commercial	$1.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.94
Rate for Payer: EmblemHealth Commercial	$0.69
Rate for Payer: Group Health Inc Commercial	$0.69
Rate for Payer: Group Health Inc Medicare	$0.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.69
Rate for Payer: Hamaspik Choice Inc Medicare	$0.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.90

ALBUMIN HUMAN 25 % IV SOLN

Facility

$1.12

Service Code	HCPCS P9074
Hospital Charge Code	6851652167
Hospital Revenue Code	258
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.56
Rate for Payer: Aetna Government	$0.56
Rate for Payer: Brighton Health Commercial	$0.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.76
Rate for Payer: EmblemHealth Commercial	$0.56
Rate for Payer: Group Health Inc Commercial	$0.56
Rate for Payer: Group Health Inc Medicare	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56
Rate for Payer: Hamaspik Choice Inc Medicare	$0.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.73

ALBUMIN HUMAN 25 % IV SOLN

Facility

$1.12

Service Code	HCPCS P9074
Hospital Charge Code	6851652167
Hospital Revenue Code	258
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56

ALBUMIN HUMAN 25 % IV SOLN

Facility

$1.12

Service Code	HCPCS P9074
Hospital Charge Code	6851652161
Hospital Revenue Code	258
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.56
Rate for Payer: Aetna Government	$0.56
Rate for Payer: Brighton Health Commercial	$0.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.76
Rate for Payer: EmblemHealth Commercial	$0.56
Rate for Payer: Group Health Inc Commercial	$0.56
Rate for Payer: Group Health Inc Medicare	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56
Rate for Payer: Hamaspik Choice Inc Medicare	$0.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.73

ALBUMIN HUMAN 25 % IV SOLN

Facility

$1.39

Service Code	HCPCS P9074
Hospital Charge Code	0944049303
Hospital Revenue Code	258
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$1.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.69
Rate for Payer: Aetna Government	$0.69
Rate for Payer: Brighton Health Commercial	$1.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.94
Rate for Payer: EmblemHealth Commercial	$0.69
Rate for Payer: Group Health Inc Commercial	$0.69
Rate for Payer: Group Health Inc Medicare	$0.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.69
Rate for Payer: Hamaspik Choice Inc Medicare	$0.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.90

ALBUMIN HUMAN 25 % IV SOLN

Facility

$1.39

Service Code	HCPCS P9074
Hospital Charge Code	0944049301
Hospital Revenue Code	258
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$0.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.69

ALBUMIN HUMAN 5 % IV SOLN

Facility

$0.22

Service Code	NDC 6851652149
Hospital Charge Code	6851652149
Hospital Revenue Code	258
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

ALBUMIN HUMAN 5 % IV SOLN

Facility

$0.22

Service Code	NDC 6851652184
Hospital Charge Code	6851652184
Hospital Revenue Code	258
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	$0.14

ALBUMIN HUMAN 5 % IV SOLN

Facility

$0.22

Service Code	NDC 6851652149
Hospital Charge Code	6851652149
Hospital Revenue Code	258
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	$0.14

ALBUMIN HUMAN 5 % IV SOLN

Facility

$0.22

Service Code	NDC 6851652184
Hospital Charge Code	6851652184
Hospital Revenue Code	258
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

ALBUMIN HUMAN 5 % IV SOLN

Facility

$0.79

Service Code	NDC 6851652145
Hospital Charge Code	6851652145
Hospital Revenue Code	258
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.39
Rate for Payer: Aetna Government	$0.39
Rate for Payer: Brighton Health Commercial	$0.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.54
Rate for Payer: EmblemHealth Commercial	$0.39
Rate for Payer: Group Health Inc Commercial	$0.39
Rate for Payer: Group Health Inc Medicare	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39
Rate for Payer: Hamaspik Choice Inc Medicare	$0.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.51

ALBUMIN HUMAN 5 % IV SOLN

Facility

$1.39

Service Code	NDC 0944049505
Hospital Charge Code	0944049505
Hospital Revenue Code	258
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$0.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.69

ALBUMIN HUMAN 5 % IV SOLN

Facility

$1.39

Service Code	NDC 0944049505
Hospital Charge Code	0944049505
Hospital Revenue Code	258
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$1.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.69
Rate for Payer: Aetna Government	$0.69
Rate for Payer: Brighton Health Commercial	$1.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.94
Rate for Payer: EmblemHealth Commercial	$0.69
Rate for Payer: Group Health Inc Commercial	$0.69
Rate for Payer: Group Health Inc Medicare	$0.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.69
Rate for Payer: Hamaspik Choice Inc Medicare	$0.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.90

Know your out-of-pocket cost for care.

All Charges