St. Barnabas Hospital

All Charges

Charge

Type

Price

SOLUTION,DEXTROSE,5,0.33,500

Facility OP

$3.28

Hospital Charge Code	64901119
Hospital Revenue Code	270
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$2.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.64
Rate for Payer: Aetna Government	$1.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.23
Rate for Payer: Group Health Inc Commercial	$1.64
Rate for Payer: Group Health Inc Medicare	$1.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.64
Rate for Payer: Hamaspik Choice Inc Medicare	$1.64

SOLUTION DEXTROSE,5,0.45,1000

Facility OP

$3.42

Service Code	HCPCS S5010
Hospital Charge Code	64901398
Hospital Revenue Code	258
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$5.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.33
Rate for Payer: Group Health Inc Commercial	$1.71
Rate for Payer: Group Health Inc Medicare	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.71
Rate for Payer: Hamaspik Choice Inc Medicare	$1.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.22

SOLUTION,DEXTROSE,5,0.45,500

Facility OP

$3.27

Hospital Charge Code	64901421
Hospital Revenue Code	270
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$2.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.64
Rate for Payer: Aetna Government	$1.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.22
Rate for Payer: Group Health Inc Commercial	$1.64
Rate for Payer: Group Health Inc Medicare	$1.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.64
Rate for Payer: Hamaspik Choice Inc Medicare	$1.64

SOLUTION,DEXTROSE,5,0.9

Facility OP

$3.28

Hospital Charge Code	64901475
Hospital Revenue Code	270
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$2.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.64
Rate for Payer: Aetna Government	$1.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.23
Rate for Payer: Group Health Inc Commercial	$1.64
Rate for Payer: Group Health Inc Medicare	$1.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.64
Rate for Payer: Hamaspik Choice Inc Medicare	$1.64

SOLUTION,DEXTROSE,5,0.9,1000

Facility OP

$3.61

Hospital Charge Code	64901418
Hospital Revenue Code	270
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$2.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.80
Rate for Payer: Aetna Government	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.45
Rate for Payer: Group Health Inc Commercial	$1.80
Rate for Payer: Group Health Inc Medicare	$1.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.80
Rate for Payer: Hamaspik Choice Inc Medicare	$1.80

SOLUTION,DEXTROSE,5,1000ML,US

Facility OP

$3.34

Service Code	HCPCS S5010
Hospital Charge Code	64901410
Hospital Revenue Code	258
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$5.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.27
Rate for Payer: Group Health Inc Commercial	$1.67
Rate for Payer: Group Health Inc Medicare	$1.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.67
Rate for Payer: Hamaspik Choice Inc Medicare	$1.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.17

SOLUTION,DEXTROSE,5 100 ML

Facility OP

$2.93

Hospital Charge Code	64901411
Hospital Revenue Code	270
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$2.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.46
Rate for Payer: Aetna Government	$1.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.99
Rate for Payer: Group Health Inc Commercial	$1.46
Rate for Payer: Group Health Inc Medicare	$1.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.46
Rate for Payer: Hamaspik Choice Inc Medicare	$1.46

SOLUTION,DEXTROSE,5,250 ML,US

Facility OP

$2.93

Service Code	HCPCS S5010
Hospital Charge Code	64901390
Hospital Revenue Code	258
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$5.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.99
Rate for Payer: Group Health Inc Commercial	$1.46
Rate for Payer: Group Health Inc Medicare	$1.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.46
Rate for Payer: Hamaspik Choice Inc Medicare	$1.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.90

SOLUTION DEXTROSE,5,500 ML,US

Facility OP

$3.03

Service Code	HCPCS S5010
Hospital Charge Code	64901394
Hospital Revenue Code	258
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$5.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.06
Rate for Payer: Group Health Inc Commercial	$1.52
Rate for Payer: Group Health Inc Medicare	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.97

SOLUTION,DEXTROSE,5,50 ML

Facility OP

$2.93

Hospital Charge Code	64901412
Hospital Revenue Code	270
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$2.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.46
Rate for Payer: Aetna Government	$1.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.99
Rate for Payer: Group Health Inc Commercial	$1.46
Rate for Payer: Group Health Inc Medicare	$1.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.46
Rate for Payer: Hamaspik Choice Inc Medicare	$1.46

SOLUTION,DEXTRSE,INJ, 5,MIN50

Facility OP

$23.59

Service Code	HCPCS S5010
Hospital Charge Code	64902282
Hospital Revenue Code	258
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$18.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.04
Rate for Payer: Group Health Inc Commercial	$11.80
Rate for Payer: Group Health Inc Medicare	$8.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.80
Rate for Payer: Hamaspik Choice Inc Medicare	$11.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.33

SOLUTION,DEXTRSE,INJ, 5,MINI0

Facility OP

$23.59

Service Code	HCPCS S5010
Hospital Charge Code	64902285
Hospital Revenue Code	258
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$18.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.04
Rate for Payer: Group Health Inc Commercial	$11.80
Rate for Payer: Group Health Inc Medicare	$8.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.80
Rate for Payer: Hamaspik Choice Inc Medicare	$11.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.33

SOLUTION,DURAPREP,APPLICATOR,26ML

Facility OP

$9.44

Hospital Charge Code	64905074
Hospital Revenue Code	270
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$7.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.72
Rate for Payer: Aetna Government	$4.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.42
Rate for Payer: Group Health Inc Commercial	$4.72
Rate for Payer: Group Health Inc Medicare	$3.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.72
Rate for Payer: Hamaspik Choice Inc Medicare	$4.72

SOLUTION,GLYCINE 1.5,IRRIGA,300

Facility OP

$16.42

Hospital Charge Code	64902537
Hospital Revenue Code	270
Min. Negotiated Rate	$5.75
Max. Negotiated Rate	$13.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.17
Rate for Payer: Group Health Inc Commercial	$8.21
Rate for Payer: Group Health Inc Medicare	$5.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.21
Rate for Payer: Hamaspik Choice Inc Medicare	$8.21

SOLUTION GYLCINE IRRIG 1.5L BTL

Facility OP

$53.15

Hospital Charge Code	64904092
Hospital Revenue Code	270
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$42.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.58
Rate for Payer: Aetna Government	$26.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.14
Rate for Payer: Group Health Inc Commercial	$26.58
Rate for Payer: Group Health Inc Medicare	$18.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.58
Rate for Payer: Hamaspik Choice Inc Medicare	$26.58

SOLUTION,PREP,POVIDONE IOD

Facility OP

$2.50

Hospital Charge Code	64901161
Hospital Revenue Code	270
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$2.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.25
Rate for Payer: Aetna Government	$1.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.70
Rate for Payer: Group Health Inc Commercial	$1.25
Rate for Payer: Group Health Inc Medicare	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25

SOLUTION QC-QC5 LVL1 RED

Facility OP

$10.35

Hospital Charge Code	64902714
Hospital Revenue Code	270
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$8.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.18
Rate for Payer: Aetna Government	$5.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.04
Rate for Payer: Group Health Inc Commercial	$5.18
Rate for Payer: Group Health Inc Medicare	$3.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.18
Rate for Payer: Hamaspik Choice Inc Medicare	$5.18

SOLUTION,RINGER'S,INJ,LACT

Facility OP

$3.42

Hospital Charge Code	64901386
Hospital Revenue Code	270
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$2.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.71
Rate for Payer: Aetna Government	$1.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.33
Rate for Payer: Group Health Inc Commercial	$1.71
Rate for Payer: Group Health Inc Medicare	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.71
Rate for Payer: Hamaspik Choice Inc Medicare	$1.71

SOLUTION,RINGERS,LACTATED,INJ

Facility OP

$0.14

Service Code	HCPCS S5010
Hospital Charge Code	64901383
Hospital Revenue Code	258
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$5.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

SOLUTION,RINGERS,LACT,INJ,10

Facility OP

$3.17

Hospital Charge Code	64901402
Hospital Revenue Code	270
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$2.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.58
Rate for Payer: Aetna Government	$1.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.16
Rate for Payer: Group Health Inc Commercial	$1.58
Rate for Payer: Group Health Inc Medicare	$1.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1.58

SOLUTION,RINGERS LACT,INJ,500

Facility OP

$2.90

Service Code	HCPCS S5010
Hospital Charge Code	64901904
Hospital Revenue Code	258
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$5.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.97
Rate for Payer: Group Health Inc Commercial	$1.45
Rate for Payer: Group Health Inc Medicare	$1.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.45
Rate for Payer: Hamaspik Choice Inc Medicare	$1.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.88

SOLUTION SET 1.8M (70 )

Facility OP

$3.55

Hospital Charge Code	40509818
Hospital Revenue Code	260
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$2.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.78
Rate for Payer: Aetna Government	$1.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.41
Rate for Payer: Group Health Inc Commercial	$1.78
Rate for Payer: Group Health Inc Medicare	$1.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.78
Rate for Payer: Hamaspik Choice Inc Medicare	$1.78

SOLUTION,SODIUM CHL,0.45,1000M

Facility OP

$3.46

Hospital Charge Code	64901415
Hospital Revenue Code	270
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$2.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.73
Rate for Payer: Aetna Government	$1.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.35
Rate for Payer: Group Health Inc Commercial	$1.73
Rate for Payer: Group Health Inc Medicare	$1.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.73
Rate for Payer: Hamaspik Choice Inc Medicare	$1.73

SOLUTION,SODIUM CHL,0.9,1000ML

Facility OP

$2.99

Hospital Charge Code	64901379
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.03
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

SOLUTION,SODIUM CHL,0.9,250ML

Facility OP

$2.60

Hospital Charge Code	64901372
Hospital Revenue Code	270
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$2.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.30
Rate for Payer: Aetna Government	$1.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.77
Rate for Payer: Group Health Inc Commercial	$1.30
Rate for Payer: Group Health Inc Medicare	$0.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1.30

Price Transparency.

All Charges