St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ALENDRONATE SODIUM 10 MG PO TABS

Facility

$2.92

Service Code	NDC 6498034001
Hospital Charge Code	6498034001
Hospital Revenue Code	250
Min. Negotiated Rate	$1.02
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: Brighton Health Commercial	$2.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.99
Rate for Payer: EmblemHealth Commercial	$1.46
Rate for Payer: Group Health Inc Commercial	$1.46
Rate for Payer: Group Health Inc Medicare	$1.02
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

ALENDRONATE SODIUM 10 MG PO TABS

Facility

$2.92

Service Code	NDC 6498034001
Hospital Charge Code	6498034001
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.46

ALENDRONATE SODIUM 35 MG PO TABS

Facility

$20.49

Service Code	NDC 6909722316
Hospital Charge Code	6909722316
Hospital Revenue Code	250
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$16.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.24
Rate for Payer: Aetna Government	$10.24
Rate for Payer: Brighton Health Commercial	$15.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.93
Rate for Payer: EmblemHealth Commercial	$10.24
Rate for Payer: Group Health Inc Commercial	$10.24
Rate for Payer: Group Health Inc Medicare	$7.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.24
Rate for Payer: Hamaspik Choice Inc Medicare	$10.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.32

ALENDRONATE SODIUM 35 MG PO TABS

Facility

$20.49

Service Code	NDC 6909722316
Hospital Charge Code	6909722316
Hospital Revenue Code	250
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$10.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.24

ALENDRONATE SODIUM 70 MG PO TABS

Facility

$20.49

Service Code	NDC 6909722416
Hospital Charge Code	6909722416
Hospital Revenue Code	250
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$10.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.24

ALENDRONATE SODIUM 70 MG PO TABS

Facility

$20.49

Service Code	NDC 6954313120
Hospital Charge Code	6954313120
Hospital Revenue Code	250
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$16.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.24
Rate for Payer: Aetna Government	$10.24
Rate for Payer: Brighton Health Commercial	$15.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.93
Rate for Payer: EmblemHealth Commercial	$10.24
Rate for Payer: Group Health Inc Commercial	$10.24
Rate for Payer: Group Health Inc Medicare	$7.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.24
Rate for Payer: Hamaspik Choice Inc Medicare	$10.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.32

ALENDRONATE SODIUM 70 MG PO TABS

Facility

$20.49

Service Code	NDC 6909722416
Hospital Charge Code	6909722416
Hospital Revenue Code	250
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$16.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.24
Rate for Payer: Aetna Government	$10.24
Rate for Payer: Brighton Health Commercial	$15.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.93
Rate for Payer: EmblemHealth Commercial	$10.24
Rate for Payer: Group Health Inc Commercial	$10.24
Rate for Payer: Group Health Inc Medicare	$7.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.24
Rate for Payer: Hamaspik Choice Inc Medicare	$10.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.32

ALENDRONATE SODIUM 70 MG PO TABS

Facility

$20.49

Service Code	NDC 6586232904
Hospital Charge Code	6586232904
Hospital Revenue Code	250
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$16.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.24
Rate for Payer: Aetna Government	$10.24
Rate for Payer: Brighton Health Commercial	$15.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.93
Rate for Payer: EmblemHealth Commercial	$10.24
Rate for Payer: Group Health Inc Commercial	$10.24
Rate for Payer: Group Health Inc Medicare	$7.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.24
Rate for Payer: Hamaspik Choice Inc Medicare	$10.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.32

ALENDRONATE SODIUM 70 MG PO TABS

Facility

$20.49

Service Code	NDC 6954313120
Hospital Charge Code	6954313120
Hospital Revenue Code	250
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$10.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.24

ALENDRONATE SODIUM 70 MG PO TABS

Facility

$20.49

Service Code	NDC 6586232904
Hospital Charge Code	6586232904
Hospital Revenue Code	250
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$10.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.24

ALIMENTARY TESTS AND TUBE INSERTION OR PLACEMENT

Facility

$873.50

Service Code	EAPG 00130
Min. Negotiated Rate	$634.12
Max. Negotiated Rate	$873.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$634.12
Rate for Payer: Healthfirst Commercial	$873.50

Allergic reactions

Facility

$37,978.81

Service Code	APR-DRG 8111
Min. Negotiated Rate	$4,206.00
Max. Negotiated Rate	$37,978.81
Rate for Payer: Affinity Essential Plan 1&2	$37,978.81
Rate for Payer: Affinity Essential Plan 3&4	$37,978.81
Rate for Payer: Affinity Medicaid/CHP/HARP	$16,879.47
Rate for Payer: Amida Care Medicaid	$16,879.47
Rate for Payer: EmblemHealth Essential Plan 1&2	$37,978.81
Rate for Payer: EmblemHealth Essential Plan 3&4	$16,879.47
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,879.47
Rate for Payer: Fidelis Qualified Health Plan	$20,255.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,879.47
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,879.47
Rate for Payer: Healthfirst Commercial	$7,216.00
Rate for Payer: Healthfirst Essential Plan	$37,978.81
Rate for Payer: Healthfirst QHP	$4,206.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,879.47
Rate for Payer: SOMOS Essential	$37,978.81
Rate for Payer: United Healthcare Essential Plan 1&2	$37,978.81
Rate for Payer: United Healthcare Essential Plan 3&4	$37,978.81
Rate for Payer: United Healthcare Medicaid	$16,879.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,879.47

Allergic reactions

Facility

$73,544.18

Service Code	APR-DRG 8114
Min. Negotiated Rate	$19,629.00
Max. Negotiated Rate	$73,544.18
Rate for Payer: Affinity Essential Plan 1&2	$73,544.18
Rate for Payer: Affinity Essential Plan 3&4	$73,544.18
Rate for Payer: Affinity Medicaid/CHP/HARP	$32,686.30
Rate for Payer: Amida Care Medicaid	$32,686.30
Rate for Payer: EmblemHealth Essential Plan 1&2	$73,544.18
Rate for Payer: EmblemHealth Essential Plan 3&4	$32,686.30
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32,686.30
Rate for Payer: Fidelis Qualified Health Plan	$39,223.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$32,686.30
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32,686.30
Rate for Payer: Healthfirst Commercial	$47,154.00
Rate for Payer: Healthfirst Essential Plan	$73,544.18
Rate for Payer: Healthfirst QHP	$19,629.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32,686.30
Rate for Payer: SOMOS Essential	$73,544.18
Rate for Payer: United Healthcare Essential Plan 1&2	$73,544.18
Rate for Payer: United Healthcare Essential Plan 3&4	$73,544.18
Rate for Payer: United Healthcare Medicaid	$32,686.30
Rate for Payer: Wellcare CHP/FHP/Medicaid	$32,686.30

Allergic reactions

Facility

$40,317.95

Service Code	APR-DRG 8112
Min. Negotiated Rate	$5,300.00
Max. Negotiated Rate	$40,317.95
Rate for Payer: Affinity Essential Plan 1&2	$40,317.95
Rate for Payer: Affinity Essential Plan 3&4	$40,317.95
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,919.09
Rate for Payer: Amida Care Medicaid	$17,919.09
Rate for Payer: EmblemHealth Essential Plan 1&2	$40,317.95
Rate for Payer: EmblemHealth Essential Plan 3&4	$17,919.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,919.09
Rate for Payer: Fidelis Qualified Health Plan	$21,502.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,919.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,919.09
Rate for Payer: Healthfirst Commercial	$9,320.00
Rate for Payer: Healthfirst Essential Plan	$40,317.95
Rate for Payer: Healthfirst QHP	$5,300.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,919.09
Rate for Payer: SOMOS Essential	$40,317.95
Rate for Payer: United Healthcare Essential Plan 1&2	$40,317.95
Rate for Payer: United Healthcare Essential Plan 3&4	$40,317.95
Rate for Payer: United Healthcare Medicaid	$17,919.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,919.09

Allergic reactions

Facility

$50,437.78

Service Code	APR-DRG 8113
Min. Negotiated Rate	$9,322.00
Max. Negotiated Rate	$50,437.78
Rate for Payer: Affinity Essential Plan 1&2	$50,437.78
Rate for Payer: Affinity Essential Plan 3&4	$50,437.78
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,416.79
Rate for Payer: Amida Care Medicaid	$22,416.79
Rate for Payer: EmblemHealth Essential Plan 1&2	$50,437.78
Rate for Payer: EmblemHealth Essential Plan 3&4	$22,416.79
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,416.79
Rate for Payer: Fidelis Qualified Health Plan	$26,900.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,416.79
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,416.79
Rate for Payer: Healthfirst Commercial	$17,190.00
Rate for Payer: Healthfirst Essential Plan	$50,437.78
Rate for Payer: Healthfirst QHP	$9,322.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,416.79
Rate for Payer: SOMOS Essential	$50,437.78
Rate for Payer: United Healthcare Essential Plan 1&2	$50,437.78
Rate for Payer: United Healthcare Essential Plan 3&4	$50,437.78
Rate for Payer: United Healthcare Medicaid	$22,416.79
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,416.79

ALLERGIC REACTIONS

Facility

$277.88

Service Code	EAPG 00850
Min. Negotiated Rate	$201.34
Max. Negotiated Rate	$277.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$201.34
Rate for Payer: Healthfirst Commercial	$277.88

ALLERGY TESTS

Facility

$439.92

Service Code	EAPG 00116
Min. Negotiated Rate	$319.37
Max. Negotiated Rate	$439.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$319.37
Rate for Payer: Healthfirst Commercial	$439.92

ALLERGY THERAPY

Facility

$57.16

Service Code	EAPG 00458
Min. Negotiated Rate	$41.66
Max. Negotiated Rate	$57.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$41.66
Rate for Payer: Healthfirst Commercial	$57.16

ALLOPURINOL 100 MG PO TABS

Facility

$0.48

Service Code	NDC 5348915601
Hospital Charge Code	5348915601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24

ALLOPURINOL 100 MG PO TABS

Facility

$0.50

Service Code	NDC 6068767711
Hospital Charge Code	6068767711
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25

ALLOPURINOL 100 MG PO TABS

Facility

$0.40

Service Code	NDC 0904704161
Hospital Charge Code	0904704161
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20

ALLOPURINOL 100 MG PO TABS

Facility

$0.30

Service Code	NDC 6373941010
Hospital Charge Code	6373941010
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15

ALLOPURINOL 100 MG PO TABS

Facility

$0.48

Service Code	NDC 0591554301
Hospital Charge Code	0591554301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.24
Rate for Payer: Aetna Government	$0.24
Rate for Payer: Brighton Health Commercial	$0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.33
Rate for Payer: EmblemHealth Commercial	$0.24
Rate for Payer: Group Health Inc Commercial	$0.24
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24
Rate for Payer: Hamaspik Choice Inc Medicare	$0.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.31

ALLOPURINOL 100 MG PO TABS

Facility

$0.50

Service Code	NDC 6068767711
Hospital Charge Code	6068767711
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.34
Rate for Payer: EmblemHealth Commercial	$0.25
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.32

ALLOPURINOL 100 MG PO TABS

Facility

$0.48

Service Code	NDC 5348915601
Hospital Charge Code	5348915601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.24
Rate for Payer: Aetna Government	$0.24
Rate for Payer: Brighton Health Commercial	$0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.33
Rate for Payer: EmblemHealth Commercial	$0.24
Rate for Payer: Group Health Inc Commercial	$0.24
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24
Rate for Payer: Hamaspik Choice Inc Medicare	$0.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.31

Know your out-of-pocket cost for care.

All Charges