St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PREDNISONE 50 MG TAB

Facility

$0.03

Service Code	HCPCS J7512
Hospital Charge Code	41643782
Hospital Revenue Code	636
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02

PREDNISONE 5 MG PO TABS [6497]

Facility

$0.20

Service Code	HCPCS J7512
Hospital Charge Code	00603533721
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.01
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.01
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.01
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

PREDNISONE 5 MG PO TABS [6497]

Facility

$0.20

Service Code	HCPCS J7512
Hospital Charge Code	60687012211
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.01
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.01
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.01
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

PREDNISONE 5 MG PO TABS [6497]

Facility

$0.23

Service Code	HCPCS J7512
Hospital Charge Code	70954005810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
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: 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: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.01
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.01
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.01
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.15

PREDNISONE 5 MG PO TABS [6497]

Facility

$0.23

Service Code	HCPCS J7512
Hospital Charge Code	00054982825
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
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: 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: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.01
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.01
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.01
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.15

PREDNISONE 5 MG PO TABS [6497]

Facility

$0.20

Service Code	HCPCS J7512
Hospital Charge Code	60687012201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.01
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.01
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.01
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

PREDNISONE 5 MG TAB

Facility

$0.06

Service Code	HCPCS J7512
Hospital Charge Code	41652665
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
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	$0.03
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: SOMOS CHP/HARP/Medicaid	$0.01
Rate for Payer: SOMOS Essential	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.04

PREDNISONE 5 MG TAB

Facility

$0.06

Service Code	HCPCS J7512
Hospital Charge Code	41642665
Hospital Revenue Code	636
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

PREDNISONE 5 MG TAB

Facility

$0.06

Service Code	HCPCS J7512
Hospital Charge Code	41642665
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
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	$0.03
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: SOMOS CHP/HARP/Medicaid	$0.01
Rate for Payer: SOMOS Essential	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.04

PREDNISONE 5 MG TAB

Facility

$0.06

Service Code	HCPCS J7512
Hospital Charge Code	41652665
Hospital Revenue Code	636
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

PR ED SVC CKD GRP PER SESSION

Professional

Both

$108.08

Service Code	HCPCS G0421
Min. Negotiated Rate	$81.06
Max. Negotiated Rate	$81.06
Rate for Payer: Cash Price	$30.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$81.06
Rate for Payer: SOMOS Essential	$81.06

PR ED SVC CKD IND PER SESSION

Professional

Both

$440.69

Service Code	HCPCS G0420
Min. Negotiated Rate	$330.52
Max. Negotiated Rate	$330.52
Rate for Payer: Cash Price	$120.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$330.52
Rate for Payer: SOMOS Essential	$330.52

PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO

Professional

Both

$828.73

Service Code	HCPCS 95721
Min. Negotiated Rate	$621.55
Max. Negotiated Rate	$621.55
Rate for Payer: Cash Price	$229.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$621.55
Rate for Payer: SOMOS Essential	$621.55

PR EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG

Professional

Both

$1,011.89

Service Code	HCPCS 95722
Min. Negotiated Rate	$758.92
Max. Negotiated Rate	$758.92
Rate for Payer: Cash Price	$279.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$758.92
Rate for Payer: SOMOS Essential	$758.92

PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO

Professional

Both

$1,012.69

Service Code	HCPCS 95723
Min. Negotiated Rate	$759.52
Max. Negotiated Rate	$759.52
Rate for Payer: Cash Price	$278.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$759.52
Rate for Payer: SOMOS Essential	$759.52

PR EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG

Professional

Both

$1,277.26

Service Code	HCPCS 95724
Min. Negotiated Rate	$957.94
Max. Negotiated Rate	$957.94
Rate for Payer: Cash Price	$349.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$957.94
Rate for Payer: SOMOS Essential	$957.94

PR EEG COMPLETE STD PHYS/QHP>84 HR W/O VID

Professional

Both

$1,157.94

Service Code	HCPCS 95725
Min. Negotiated Rate	$868.46
Max. Negotiated Rate	$868.46
Rate for Payer: Cash Price	$321.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$868.46
Rate for Payer: SOMOS Essential	$868.46

PR EEG COMPLETE STD PHYS/QHP>84 HR W/VEEG

Professional

Both

$1,625.58

Service Code	HCPCS 95726
Min. Negotiated Rate	$1,219.18
Max. Negotiated Rate	$1,219.18
Rate for Payer: Cash Price	$449.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,219.18
Rate for Payer: SOMOS Essential	$1,219.18

PR EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS

Professional

Both

$746.03

Service Code	HCPCS 95700
Min. Negotiated Rate	$559.52
Max. Negotiated Rate	$559.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$559.52
Rate for Payer: SOMOS Essential	$559.52

PR EEG EXTENDED MONITORING 61-119 MINUTES

Professional

Both

$338.31

Service Code	HCPCS 95813 26
Min. Negotiated Rate	$253.73
Max. Negotiated Rate	$253.73
Rate for Payer: Cash Price	$93.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$253.73
Rate for Payer: SOMOS Essential	$253.73

PR EEG EXTENDED MONITORING 61-119 MINUTES

Professional

Both

$1,827.00

Service Code	HCPCS 95813
Min. Negotiated Rate	$1,370.25
Max. Negotiated Rate	$1,370.25
Rate for Payer: Cash Price	$518.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,370.25
Rate for Payer: SOMOS Essential	$1,370.25

PR EEG EXTENDED MONITORING 61-119 MINUTES

Professional

Both

$1,488.69

Service Code	HCPCS 95813 TC
Min. Negotiated Rate	$1,116.52
Max. Negotiated Rate	$1,116.52
Rate for Payer: Cash Price	$424.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,116.52
Rate for Payer: SOMOS Essential	$1,116.52

PR EEG NONINTRACRANIAL SURGERY

Professional

Both

$209.34

Service Code	HCPCS 95955 26
Min. Negotiated Rate	$157.00
Max. Negotiated Rate	$157.00
Rate for Payer: Cash Price	$57.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$157.00
Rate for Payer: SOMOS Essential	$157.00

PR EEG NONINTRACRANIAL SURGERY

Professional

Both

$605.05

Service Code	HCPCS 95955 TC
Min. Negotiated Rate	$453.79
Max. Negotiated Rate	$453.79
Rate for Payer: Cash Price	$163.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$453.79
Rate for Payer: SOMOS Essential	$453.79

PR EEG NONINTRACRANIAL SURGERY

Professional

Both

$814.38

Service Code	HCPCS 95955
Min. Negotiated Rate	$610.78
Max. Negotiated Rate	$610.78
Rate for Payer: Cash Price	$221.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$610.78
Rate for Payer: SOMOS Essential	$610.78

Know your out-of-pocket cost for care.

All Charges