St. Barnabas Hospital

All Charges

Charge

Type

Price

SUCCINYLCHOLINE 100MG/5ML PFS

Facility OP

$31.25

Service Code	HCPCS J0330
Hospital Charge Code	41640231
Hospital Revenue Code	636
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$20.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.06
Rate for Payer: Aetna Government	$1.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.97
Rate for Payer: Group Health Inc Commercial	$15.62
Rate for Payer: Group Health Inc Medicare	$10.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.62
Rate for Payer: Hamaspik Choice Inc Medicare	$15.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.31

SUCCINYLCHOLINE 100MG/5ML PFS

Facility OP

$31.25

Service Code	HCPCS J0330
Hospital Charge Code	41650231
Hospital Revenue Code	636
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$20.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.06
Rate for Payer: Aetna Government	$1.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.97
Rate for Payer: Group Health Inc Commercial	$15.62
Rate for Payer: Group Health Inc Medicare	$10.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.62
Rate for Payer: Hamaspik Choice Inc Medicare	$15.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.31

SUCCINYLCHOLINE 20 MG/ML INJ

Facility IP

$0.76

Service Code	HCPCS J0330
Hospital Charge Code	41654141
Hospital Revenue Code	636
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.38
Rate for Payer: Hamaspik Choice Inc Medicare	$0.38

SUCCINYLCHOLINE 20 MG/ML INJ

Facility OP

$0.76

Service Code	HCPCS J0330
Hospital Charge Code	41644141
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$1.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.06
Rate for Payer: Aetna Government	$1.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.44
Rate for Payer: Group Health Inc Commercial	$0.38
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.38
Rate for Payer: Hamaspik Choice Inc Medicare	$0.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.49

SUCCINYLCHOLINE 20 MG/ML INJ

Facility IP

$0.76

Service Code	HCPCS J0330
Hospital Charge Code	41644141
Hospital Revenue Code	636
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.38
Rate for Payer: Hamaspik Choice Inc Medicare	$0.38

SUCCINYLCHOLINE 20 MG/ML INJ

Facility OP

$0.76

Service Code	HCPCS J0330
Hospital Charge Code	41654141
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$1.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.06
Rate for Payer: Aetna Government	$1.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.44
Rate for Payer: Group Health Inc Commercial	$0.38
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.38
Rate for Payer: Hamaspik Choice Inc Medicare	$0.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.49

SUCRALFATE 1 GRAM TAB

Facility OP

$0.45

Hospital Charge Code	41651607
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

SUCRALFATE 1 GRAM TAB

Facility OP

$0.45

Hospital Charge Code	41641607
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

SUCRALFATE SUSPENSION 1 GRAM/10 ML

Facility OP

$6.53

Hospital Charge Code	41653471
Hospital Revenue Code	250
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$5.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.26
Rate for Payer: Aetna Government	$3.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.44
Rate for Payer: Group Health Inc Commercial	$3.26
Rate for Payer: Group Health Inc Medicare	$2.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.26
Rate for Payer: Hamaspik Choice Inc Medicare	$3.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.24

SUCRALFATE SUSPENSION 1 GRAM/10 ML

Facility OP

$6.53

Hospital Charge Code	41643471
Hospital Revenue Code	250
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$5.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.26
Rate for Payer: Aetna Government	$3.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.44
Rate for Payer: Group Health Inc Commercial	$3.26
Rate for Payer: Group Health Inc Medicare	$2.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.26
Rate for Payer: Hamaspik Choice Inc Medicare	$3.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.24

SUCTION ASSISTED LIPECTOMY

Facility OP

$9,017.48

Service Code	HCPCS 15877
Hospital Charge Code	40014344
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$4,508.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,148.81
Rate for Payer: Aetna Government	$4,148.81
Rate for Payer: Cash Price	$4,148.81
Rate for Payer: Cash Price	$4,148.81
Rate for Payer: Cash Price	$4,148.81
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4,148.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$4,148.81
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,526.49
Rate for Payer: Fidelis Essential Plan QHP	$3,692.44
Rate for Payer: Fidelis Medicare Advantage	$4,148.81
Rate for Payer: Fidelis Qualified Health Plan	$3,692.44
Rate for Payer: Group Health Inc Commercial	$4,148.81
Rate for Payer: Group Health Inc Medicare	$4,148.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,508.74
Rate for Payer: Hamaspik Choice Inc Medicare	$4,148.81
Rate for Payer: Healthfirst Medicare Advantage	$3,526.49
Rate for Payer: Healthfirst QHP	$4,148.81
Rate for Payer: Senior Whole Health Medicare Advantage	$4,148.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,148.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,319.05
Rate for Payer: Wellcare Medicare	$3,941.37

SUCTION CATHETERS

Facility OP

$9.57

Hospital Charge Code	40205745
Hospital Revenue Code	270
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$7.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.78
Rate for Payer: Aetna Government	$4.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.51
Rate for Payer: Group Health Inc Commercial	$4.78
Rate for Payer: Group Health Inc Medicare	$3.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.78
Rate for Payer: Hamaspik Choice Inc Medicare	$4.78

SUCTION DEVICE W/COVER PREEMIE

Facility OP

$5.67

Hospital Charge Code	64902812
Hospital Revenue Code	270
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$4.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.84
Rate for Payer: Aetna Government	$2.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.86
Rate for Payer: Group Health Inc Commercial	$2.84
Rate for Payer: Group Health Inc Medicare	$1.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.84
Rate for Payer: Hamaspik Choice Inc Medicare	$2.84

SUCTION FRAZIER 10FR W/VENT

Facility OP

$140.00

Hospital Charge Code	40200212
Hospital Revenue Code	270
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$112.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.00
Rate for Payer: Aetna Government	$70.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.20
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00

SUCTION LIPECTOMY, L EXTR

Facility OP

$9,017.48

Service Code	HCPCS 15879
Hospital Charge Code	40019930
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$4,508.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,148.81
Rate for Payer: Aetna Government	$4,148.81
Rate for Payer: Cash Price	$4,148.81
Rate for Payer: Cash Price	$4,148.81
Rate for Payer: Cash Price	$4,148.81
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4,148.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$4,148.81
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,526.49
Rate for Payer: Fidelis Essential Plan QHP	$3,692.44
Rate for Payer: Fidelis Medicare Advantage	$4,148.81
Rate for Payer: Fidelis Qualified Health Plan	$3,692.44
Rate for Payer: Group Health Inc Commercial	$4,148.81
Rate for Payer: Group Health Inc Medicare	$4,148.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,508.74
Rate for Payer: Hamaspik Choice Inc Medicare	$4,148.81
Rate for Payer: Healthfirst Medicare Advantage	$3,526.49
Rate for Payer: Healthfirst QHP	$4,148.81
Rate for Payer: Senior Whole Health Medicare Advantage	$4,148.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,148.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,319.05
Rate for Payer: Wellcare Medicare	$3,941.37

SUCTION MACHINE, PER DAY

Facility OP

$45.36

Hospital Charge Code	40200840
Hospital Revenue Code	270
Min. Negotiated Rate	$15.88
Max. Negotiated Rate	$36.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.68
Rate for Payer: Aetna Government	$22.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.84
Rate for Payer: Group Health Inc Commercial	$22.68
Rate for Payer: Group Health Inc Medicare	$15.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.68
Rate for Payer: Hamaspik Choice Inc Medicare	$22.68

suction tips

Facility OP

$1.77

Hospital Charge Code	40000345
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$1.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.89
Rate for Payer: Aetna Government	$0.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.20
Rate for Payer: Group Health Inc Commercial	$0.89
Rate for Payer: Group Health Inc Medicare	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.89
Rate for Payer: Hamaspik Choice Inc Medicare	$0.89

SUCTION TUBING

Facility OP

$7.80

Hospital Charge Code	40000350
Hospital Revenue Code	272
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$6.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.90
Rate for Payer: Aetna Government	$3.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.30
Rate for Payer: Group Health Inc Commercial	$3.90
Rate for Payer: Group Health Inc Medicare	$2.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.90
Rate for Payer: Hamaspik Choice Inc Medicare	$3.90

SUGAMMADEX 200MG/2ML INJ

Facility OP

$236.18

Service Code	HCPCS J3490
Hospital Charge Code	41646626
Hospital Revenue Code	636
Min. Negotiated Rate	$82.66
Max. Negotiated Rate	$153.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.09
Rate for Payer: Aetna Government	$118.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$118.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$135.80
Rate for Payer: Group Health Inc Commercial	$118.09
Rate for Payer: Group Health Inc Medicare	$82.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.09
Rate for Payer: Hamaspik Choice Inc Medicare	$118.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$153.52

SUGAMMADEX 200MG/2ML INJ

Facility IP

$236.18

Service Code	HCPCS J3490
Hospital Charge Code	41656626
Hospital Revenue Code	636
Min. Negotiated Rate	$118.09
Max. Negotiated Rate	$118.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.09
Rate for Payer: Hamaspik Choice Inc Medicare	$118.09

SUGAMMADEX 200MG/2ML INJ

Facility IP

$236.18

Service Code	HCPCS J3490
Hospital Charge Code	41646626
Hospital Revenue Code	636
Min. Negotiated Rate	$118.09
Max. Negotiated Rate	$118.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.09
Rate for Payer: Hamaspik Choice Inc Medicare	$118.09

SUGAMMADEX 200MG/2ML INJ

Facility OP

$236.18

Service Code	HCPCS J3490
Hospital Charge Code	41656626
Hospital Revenue Code	636
Min. Negotiated Rate	$82.66
Max. Negotiated Rate	$153.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.09
Rate for Payer: Aetna Government	$118.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$118.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$135.80
Rate for Payer: Group Health Inc Commercial	$118.09
Rate for Payer: Group Health Inc Medicare	$82.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.09
Rate for Payer: Hamaspik Choice Inc Medicare	$118.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$153.52

SUGAMMADEX 500MG/5ML INJ

Facility IP

$432.59

Service Code	HCPCS J3490
Hospital Charge Code	41656627
Hospital Revenue Code	636
Min. Negotiated Rate	$216.30
Max. Negotiated Rate	$216.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$216.30
Rate for Payer: Hamaspik Choice Inc Medicare	$216.30

SUGAMMADEX 500MG/5ML INJ

Facility IP

$432.59

Service Code	HCPCS J3490
Hospital Charge Code	41646627
Hospital Revenue Code	636
Min. Negotiated Rate	$216.30
Max. Negotiated Rate	$216.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$216.30
Rate for Payer: Hamaspik Choice Inc Medicare	$216.30

SUGAMMADEX 500MG/5ML INJ

Facility OP

$432.59

Service Code	HCPCS J3490
Hospital Charge Code	41646627
Hospital Revenue Code	636
Min. Negotiated Rate	$151.41
Max. Negotiated Rate	$281.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$237.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$216.30
Rate for Payer: Aetna Government	$216.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$216.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$248.74
Rate for Payer: Group Health Inc Commercial	$216.30
Rate for Payer: Group Health Inc Medicare	$151.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$216.30
Rate for Payer: Hamaspik Choice Inc Medicare	$216.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$281.18

Price Transparency.

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