St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CIPROFLOXACIN IN D5W 200 MG/100ML IV SOLN

Facility

$0.03

Service Code	HCPCS J0744
Hospital Charge Code	0409230024
Hospital Revenue Code	258
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

CIPROFLOXACIN IN D5W 200 MG/100ML IV SOLN

Facility

$0.04

Service Code	HCPCS J0744
Hospital Charge Code	3600000824
Hospital Revenue Code	258
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

CIPROFLOXACIN IN D5W 200 MG/100ML IV SOLN

Facility

$0.04

Service Code	HCPCS J0744
Hospital Charge Code	3600000824
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.08
Rate for Payer: Aetna Government	$1.08
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN

Facility

$0.02

Service Code	HCPCS J0744
Hospital Charge Code	0409330024
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.08
Rate for Payer: Aetna Government	$1.08
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: EmblemHealth Commercial	$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: Healthfirst CHP/FHP/Medicaid	$2.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN

Facility

$0.02

Service Code	HCPCS J0744
Hospital Charge Code	0409330001
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN

Facility

$0.04

Service Code	HCPCS J0744
Hospital Charge Code	2502119287
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.08
Rate for Payer: Aetna Government	$1.08
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN

Facility

$0.02

Service Code	HCPCS J0744
Hospital Charge Code	0409330001
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.08
Rate for Payer: Aetna Government	$1.08
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: EmblemHealth Commercial	$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: Healthfirst CHP/FHP/Medicaid	$2.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN

Facility

$0.02

Service Code	HCPCS J0744
Hospital Charge Code	0409330024
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN

Facility

$0.04

Service Code	HCPCS J0744
Hospital Charge Code	2502111487
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.08
Rate for Payer: Aetna Government	$1.08
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN

Facility

$0.04

Service Code	HCPCS J0744
Hospital Charge Code	2502111487
Hospital Revenue Code	258
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN

Facility

$0.04

Service Code	HCPCS J0744
Hospital Charge Code	2502119287
Hospital Revenue Code	258
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

CIPROFLOXACIN IV SYRINGE 2 MG/ML IN D5W (NEO/PED)

Facility

$0.02

Service Code	HCPCS J0744
Hospital Charge Code	3600029724
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.08
Rate for Payer: Aetna Government	$1.08
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: EmblemHealth Commercial	$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: Healthfirst CHP/FHP/Medicaid	$2.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CIPROFLOXACIN IV SYRINGE 2 MG/ML IN D5W (NEO/PED)

Facility

$0.03

Service Code	HCPCS J0744
Hospital Charge Code	0409230001
Hospital Revenue Code	258
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

CIPROFLOXACIN IV SYRINGE 2 MG/ML IN D5W (NEO/PED)

Facility

$0.03

Service Code	HCPCS J0744
Hospital Charge Code	0409230001
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.08
Rate for Payer: Aetna Government	$1.08
Rate for Payer: Brighton Health Commercial	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

CIPROFLOXACIN IV SYRINGE 2 MG/ML IN D5W (NEO/PED)

Facility

$0.02

Service Code	HCPCS J0744
Hospital Charge Code	3600029724
Hospital Revenue Code	258
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

CISATRACURIUM BESYLATE 20 MG/10ML IV SOLN

Facility

$2.76

Service Code	NDC 7006916110
Hospital Charge Code	7006916110
Hospital Revenue Code	258
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$2.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.38
Rate for Payer: Aetna Government	$1.38
Rate for Payer: Brighton Health Commercial	$2.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.88
Rate for Payer: EmblemHealth Commercial	$1.38
Rate for Payer: Group Health Inc Commercial	$1.38
Rate for Payer: Group Health Inc Medicare	$0.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.79

CISATRACURIUM BESYLATE 20 MG/10ML IV SOLN

Facility

$2.76

Service Code	NDC 7006916110
Hospital Charge Code	7006916110
Hospital Revenue Code	258
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$1.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.38

CISATRACURIUM BESYLATE (PF) 10 MG/5ML IV SOLN

Facility

$3.39

Service Code	NDC 0409109812
Hospital Charge Code	0409109812
Hospital Revenue Code	258
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$2.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$2.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.31
Rate for Payer: EmblemHealth Commercial	$1.70
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.21

CISATRACURIUM BESYLATE (PF) 10 MG/5ML IV SOLN

Facility

$1.68

Service Code	NDC 7128871205
Hospital Charge Code	7128871205
Hospital Revenue Code	258
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$1.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.84
Rate for Payer: Aetna Government	$0.84
Rate for Payer: Brighton Health Commercial	$1.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.14
Rate for Payer: EmblemHealth Commercial	$0.84
Rate for Payer: Group Health Inc Commercial	$0.84
Rate for Payer: Group Health Inc Medicare	$0.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84
Rate for Payer: Hamaspik Choice Inc Medicare	$0.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.09

CISATRACURIUM BESYLATE (PF) 10 MG/5ML IV SOLN

Facility

$3.36

Service Code	NDC 7006914110
Hospital Charge Code	7006914110
Hospital Revenue Code	258
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$2.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$2.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.28
Rate for Payer: EmblemHealth Commercial	$1.68
Rate for Payer: Group Health Inc Commercial	$1.68
Rate for Payer: Group Health Inc Medicare	$1.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.18

CISATRACURIUM BESYLATE (PF) 10 MG/5ML IV SOLN

Facility

$3.39

Service Code	NDC 0409109812
Hospital Charge Code	0409109812
Hospital Revenue Code	258
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70

CISATRACURIUM BESYLATE (PF) 10 MG/5ML IV SOLN

Facility

$1.68

Service Code	NDC 7128871205
Hospital Charge Code	7128871205
Hospital Revenue Code	258
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.84

CISATRACURIUM BESYLATE (PF) 10 MG/5ML IV SOLN

Facility

$3.39

Service Code	NDC 0409109802
Hospital Charge Code	0409109802
Hospital Revenue Code	258
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$2.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$2.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.31
Rate for Payer: EmblemHealth Commercial	$1.70
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.21

CISATRACURIUM BESYLATE (PF) 10 MG/5ML IV SOLN

Facility

$3.39

Service Code	NDC 0409109802
Hospital Charge Code	0409109802
Hospital Revenue Code	258
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70

CISATRACURIUM BESYLATE (PF) 10 MG/5ML IV SOLN

Facility

$3.36

Service Code	NDC 7006914110
Hospital Charge Code	7006914110
Hospital Revenue Code	258
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68

Know your out-of-pocket cost for care.

All Charges