St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ATROPINE 0.1 MG/ML SYRINGE INJ 10 ML

Facility

$21.40

Service Code	HCPCS J0461
Hospital Charge Code	41655521
Hospital Revenue Code	636
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$13.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$12.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.30
Rate for Payer: Group Health Inc Commercial	$10.70
Rate for Payer: Group Health Inc Medicare	$7.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.70
Rate for Payer: Hamaspik Choice Inc Medicare	$10.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.07
Rate for Payer: SOMOS Essential	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.91

ATROPINE 0.1 MG/ML SYRINGE INJ 10 ML

Facility

$21.40

Service Code	HCPCS J0461
Hospital Charge Code	41645521
Hospital Revenue Code	636
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$13.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$12.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.30
Rate for Payer: Group Health Inc Commercial	$10.70
Rate for Payer: Group Health Inc Medicare	$7.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.70
Rate for Payer: Hamaspik Choice Inc Medicare	$10.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.07
Rate for Payer: SOMOS Essential	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.91

ATROPINE 0.1 MG/ML SYRINGE INJ 10 ML

Facility

$21.40

Service Code	HCPCS J0461
Hospital Charge Code	41645521
Hospital Revenue Code	636
Min. Negotiated Rate	$10.70
Max. Negotiated Rate	$10.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.70
Rate for Payer: Hamaspik Choice Inc Medicare	$10.70

ATROPINE 0.1 MG/ML SYRINGE INJ 10 ML

Facility

$21.40

Service Code	HCPCS J0461
Hospital Charge Code	41655521
Hospital Revenue Code	636
Min. Negotiated Rate	$10.70
Max. Negotiated Rate	$10.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.70
Rate for Payer: Hamaspik Choice Inc Medicare	$10.70

ATROPINE 0.4 MG/ML INJ

Facility

$2.98

Service Code	HCPCS J0461
Hospital Charge Code	41651489
Hospital Revenue Code	636
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.49
Rate for Payer: Hamaspik Choice Inc Medicare	$1.49

ATROPINE 0.4 MG/ML INJ

Facility

$2.98

Service Code	HCPCS J0461
Hospital Charge Code	41651489
Hospital Revenue Code	636
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$1.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.71
Rate for Payer: Group Health Inc Commercial	$1.49
Rate for Payer: Group Health Inc Medicare	$1.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.49
Rate for Payer: Hamaspik Choice Inc Medicare	$1.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.07
Rate for Payer: SOMOS Essential	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.94

ATROPINE 0.4 MG/ML INJ

Facility

$2.98

Service Code	HCPCS J0461
Hospital Charge Code	41641489
Hospital Revenue Code	636
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$1.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.71
Rate for Payer: Group Health Inc Commercial	$1.49
Rate for Payer: Group Health Inc Medicare	$1.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.49
Rate for Payer: Hamaspik Choice Inc Medicare	$1.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.07
Rate for Payer: SOMOS Essential	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.94

ATROPINE 0.4 MG/ML INJ

Facility

$2.98

Service Code	HCPCS J0461
Hospital Charge Code	41641489
Hospital Revenue Code	636
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.49
Rate for Payer: Hamaspik Choice Inc Medicare	$1.49

ATROPINE 1 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J0461
Hospital Charge Code	41653819
Hospital Revenue Code	636
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
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
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.07
Rate for Payer: SOMOS Essential	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

ATROPINE 1 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J0461
Hospital Charge Code	41643819
Hospital Revenue Code	636
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
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
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.07
Rate for Payer: SOMOS Essential	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

ATROPINE 1 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J0461
Hospital Charge Code	41653819
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

ATROPINE 1 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J0461
Hospital Charge Code	41643819
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

ATROPINE 1% OPHTHALMIC OINT

Facility

$3.00

Hospital Charge Code	41652198
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

ATROPINE 1% OPHTHALMIC OINT

Facility

$3.00

Hospital Charge Code	41642198
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

ATROPINE 1% OPHTHALMIC SOLN

Facility

$1.00

Hospital Charge Code	41653540
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

ATROPINE 1% OPHTHALMIC SOLN

Facility

$1.00

Hospital Charge Code	41643540
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

ATROPINE-PRALIDOXIME INJ

Facility

$78.00

Hospital Charge Code	41654785
Hospital Revenue Code	250
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$62.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$42.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$39.00
Rate for Payer: Aetna Government	$39.00
Rate for Payer: Brighton Health Commercial	$58.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$62.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$53.04
Rate for Payer: Group Health Inc Commercial	$39.00
Rate for Payer: Group Health Inc Medicare	$27.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$39.00
Rate for Payer: Hamaspik Choice Inc Medicare	$39.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$50.70

ATROPINE-PRALIDOXIME INJ

Facility

$78.00

Hospital Charge Code	41644785
Hospital Revenue Code	250
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$62.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$42.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$39.00
Rate for Payer: Aetna Government	$39.00
Rate for Payer: Brighton Health Commercial	$58.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$62.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$53.04
Rate for Payer: Group Health Inc Commercial	$39.00
Rate for Payer: Group Health Inc Medicare	$27.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$39.00
Rate for Payer: Hamaspik Choice Inc Medicare	$39.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$50.70

ATROPINE SULFATE 1 MG/10ML IJ SOSY [137072]

Facility

$1.12

Service Code	HCPCS J0461
Hospital Charge Code	00409163010
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$0.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.76
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: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.07
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.07
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.07
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.73

ATROPINE SULFATE 1 MG/10ML IJ SOSY [137072]

Facility

$1.37

Service Code	HCPCS J0461
Hospital Charge Code	76329334001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$1.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.93
Rate for Payer: Group Health Inc Commercial	$0.69
Rate for Payer: Group Health Inc Medicare	$0.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.69
Rate for Payer: Hamaspik Choice Inc Medicare	$0.69
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.07
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.07
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.07
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.89

ATROPINE SULFATE 1 MG/ML IV SOLN [177368]

Facility

$22.61

Service Code	NDC 16729052663
Hospital Charge Code	16729052663
Hospital Revenue Code	278
Min. Negotiated Rate	$7.91
Max. Negotiated Rate	$23.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.30
Rate for Payer: Aetna Government	$11.30
Rate for Payer: Brighton Health Commercial	$13.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.00
Rate for Payer: EmblemHealth Commercial	$11.30
Rate for Payer: Fidelis Medicare Advantage	$23.74
Rate for Payer: Group Health Inc Commercial	$11.30
Rate for Payer: Group Health Inc Medicare	$7.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.30
Rate for Payer: Hamaspik Choice Inc Medicare	$11.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.70

ATROPINE SULFATE 1 MG/ML IV SOLN [177368]

Facility

$22.61

Service Code	NDC 16729052663
Hospital Charge Code	16729052663
Hospital Revenue Code	278
Min. Negotiated Rate	$11.30
Max. Negotiated Rate	$11.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.30
Rate for Payer: Hamaspik Choice Inc Medicare	$11.30

ATROPINE SULFATE 1 % OP SOLN [736]

Facility

$23.82

Service Code	NDC 00065081702
Hospital Charge Code	00065081702
Hospital Revenue Code	250
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$19.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.91
Rate for Payer: Aetna Government	$11.91
Rate for Payer: Brighton Health Commercial	$17.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.20
Rate for Payer: Group Health Inc Commercial	$11.91
Rate for Payer: Group Health Inc Medicare	$8.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.91
Rate for Payer: Hamaspik Choice Inc Medicare	$11.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.48

ATROPINE SULFATE 1 % OP SOLN [736]

Facility

$23.93

Service Code	NDC 60219174802
Hospital Charge Code	60219174802
Hospital Revenue Code	250
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$19.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.96
Rate for Payer: Aetna Government	$11.96
Rate for Payer: Brighton Health Commercial	$17.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.27
Rate for Payer: Group Health Inc Commercial	$11.96
Rate for Payer: Group Health Inc Medicare	$8.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.96
Rate for Payer: Hamaspik Choice Inc Medicare	$11.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.55

ATROPINE SULFATE (PF) 0.4 MG/ML IJ SOLN [191013]

Facility

$9.60

Service Code	NDC 00517040125
Hospital Charge Code	00517040125
Hospital Revenue Code	250
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$7.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.80
Rate for Payer: Aetna Government	$4.80
Rate for Payer: Brighton Health Commercial	$7.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.53
Rate for Payer: Group Health Inc Commercial	$4.80
Rate for Payer: Group Health Inc Medicare	$3.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.80
Rate for Payer: Hamaspik Choice Inc Medicare	$4.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.24

Know your out-of-pocket cost for care.

All Charges