St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ROCKY MTN SPOTTED FEV, IGG, QN

Facility

$48.38

Service Code	HCPCS 86757
Hospital Charge Code	40729835
Hospital Revenue Code	302
Min. Negotiated Rate	$13.54
Max. Negotiated Rate	$36.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.35
Rate for Payer: Aetna Government	$19.35
Rate for Payer: Affinity Essential Plan 1&2	$13.54
Rate for Payer: Affinity Essential Plan 3&4	$13.54
Rate for Payer: Affinity Medicaid/CHP/HARP	$13.54
Rate for Payer: Brighton Health Commercial	$36.28
Rate for Payer: Cash Price	$19.35
Rate for Payer: Cash Price	$19.35
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$19.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.03
Rate for Payer: Elderplan Medicare Advantage	$19.35
Rate for Payer: EmblemHealth Commercial	$19.35
Rate for Payer: Fidelis Essential Plan Aliesa	$16.45
Rate for Payer: Fidelis Essential Plan QHP	$17.22
Rate for Payer: Fidelis Medicare Advantage	$19.35
Rate for Payer: Fidelis Qualified Health Plan	$17.22
Rate for Payer: Group Health Inc Commercial	$19.35
Rate for Payer: Group Health Inc Medicare	$19.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.19
Rate for Payer: Hamaspik Choice Inc Medicare	$19.35
Rate for Payer: Healthfirst Medicare Advantage	$19.35
Rate for Payer: Healthfirst QHP	$19.35
Rate for Payer: Humana Medicare	$19.74
Rate for Payer: Senior Whole Health Medicare Advantage	$19.35
Rate for Payer: United Healthcare Commercial	$24.51
Rate for Payer: United Healthcare Medicare Advantage	$19.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$19.35
Rate for Payer: Wellcare CHP/FHP/Medicaid	$15.48
Rate for Payer: Wellcare Medicare	$17.42

ROCURONIUM 10 MG/ML INJ

Facility

$7.00

Service Code	HCPCS J3490
Hospital Charge Code	41640534
Hospital Revenue Code	636
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$4.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Brighton Health Commercial	$4.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.02
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

ROCURONIUM 10 MG/ML INJ

Facility

$7.00

Service Code	HCPCS J3490
Hospital Charge Code	41640534
Hospital Revenue Code	636
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50

ROCURONIUM 10 MG/ML INJ

Facility

$7.00

Service Code	HCPCS J3490
Hospital Charge Code	41650534
Hospital Revenue Code	636
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50

ROCURONIUM 10 MG/ML INJ

Facility

$7.00

Service Code	HCPCS J3490
Hospital Charge Code	41650534
Hospital Revenue Code	636
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$4.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Brighton Health Commercial	$4.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.02
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

ROCURONIUM 200MG/100ML

Facility

$33.29

Hospital Charge Code	41640225
Hospital Revenue Code	636
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$21.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.64
Rate for Payer: Aetna Government	$16.64
Rate for Payer: Brighton Health Commercial	$19.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.14
Rate for Payer: Group Health Inc Commercial	$16.64
Rate for Payer: Group Health Inc Medicare	$11.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.64
Rate for Payer: Hamaspik Choice Inc Medicare	$16.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.64

ROCURONIUM 200MG/100ML

Facility

$33.29

Hospital Charge Code	41640225
Hospital Revenue Code	636
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$16.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.64
Rate for Payer: Hamaspik Choice Inc Medicare	$16.64

ROCURONIUM 200MG/100ML

Facility

$33.29

Hospital Charge Code	41650225
Hospital Revenue Code	636
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$16.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.64
Rate for Payer: Hamaspik Choice Inc Medicare	$16.64

ROCURONIUM 200MG/100ML

Facility

$33.29

Hospital Charge Code	41650225
Hospital Revenue Code	636
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$21.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.64
Rate for Payer: Aetna Government	$16.64
Rate for Payer: Brighton Health Commercial	$19.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.14
Rate for Payer: Group Health Inc Commercial	$16.64
Rate for Payer: Group Health Inc Medicare	$11.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.64
Rate for Payer: Hamaspik Choice Inc Medicare	$16.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.64

ROCURONIUM 500MG/NS 100ML

Facility

$110.40

Service Code	HCPCS J3490
Hospital Charge Code	41640346
Hospital Revenue Code	636
Min. Negotiated Rate	$55.20
Max. Negotiated Rate	$55.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.20
Rate for Payer: Hamaspik Choice Inc Medicare	$55.20

ROCURONIUM 500MG/NS 100ML

Facility

$110.40

Service Code	HCPCS J3490
Hospital Charge Code	41650346
Hospital Revenue Code	636
Min. Negotiated Rate	$55.20
Max. Negotiated Rate	$55.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.20
Rate for Payer: Hamaspik Choice Inc Medicare	$55.20

ROCURONIUM 500MG/NS 100ML

Facility

$110.40

Service Code	HCPCS J3490
Hospital Charge Code	41650346
Hospital Revenue Code	636
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$71.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$60.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$55.20
Rate for Payer: Aetna Government	$55.20
Rate for Payer: Brighton Health Commercial	$66.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.48
Rate for Payer: Group Health Inc Commercial	$55.20
Rate for Payer: Group Health Inc Medicare	$38.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.20
Rate for Payer: Hamaspik Choice Inc Medicare	$55.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$71.76

ROCURONIUM 500MG/NS 100ML

Facility

$110.40

Service Code	HCPCS J3490
Hospital Charge Code	41640346
Hospital Revenue Code	636
Min. Negotiated Rate	$38.64
Max. Negotiated Rate	$71.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$60.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$55.20
Rate for Payer: Aetna Government	$55.20
Rate for Payer: Brighton Health Commercial	$66.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.48
Rate for Payer: Group Health Inc Commercial	$55.20
Rate for Payer: Group Health Inc Medicare	$38.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.20
Rate for Payer: Hamaspik Choice Inc Medicare	$55.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$71.76

ROCURONIUM BROMIDE 100 MG/10ML IV SOLN [95812]

Facility

$1.63

Service Code	NDC 63323042610
Hospital Charge Code	63323042610
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$1.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.81
Rate for Payer: Aetna Government	$0.81
Rate for Payer: Brighton Health Commercial	$0.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.93
Rate for Payer: EmblemHealth Commercial	$0.81
Rate for Payer: Fidelis Medicare Advantage	$1.71
Rate for Payer: Group Health Inc Commercial	$0.81
Rate for Payer: Group Health Inc Medicare	$0.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.81
Rate for Payer: Hamaspik Choice Inc Medicare	$0.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.06

ROCURONIUM BROMIDE 100 MG/10ML IV SOLN [95812]

Facility

$1.63

Service Code	NDC 63323042610
Hospital Charge Code	63323042610
Hospital Revenue Code	278
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.81
Rate for Payer: Hamaspik Choice Inc Medicare	$0.81

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$2.10

Service Code	NDC 55150022505
Hospital Charge Code	55150022505
Hospital Revenue Code	278
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1.05

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$1.63

Service Code	NDC 63323042602
Hospital Charge Code	63323042602
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$1.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.81
Rate for Payer: Aetna Government	$0.81
Rate for Payer: Brighton Health Commercial	$0.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.93
Rate for Payer: EmblemHealth Commercial	$0.81
Rate for Payer: Fidelis Medicare Advantage	$1.71
Rate for Payer: Group Health Inc Commercial	$0.81
Rate for Payer: Group Health Inc Medicare	$0.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.81
Rate for Payer: Hamaspik Choice Inc Medicare	$0.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.06

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$1.63

Service Code	NDC 63323042605
Hospital Charge Code	63323042605
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$1.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.81
Rate for Payer: Aetna Government	$0.81
Rate for Payer: Brighton Health Commercial	$0.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.93
Rate for Payer: EmblemHealth Commercial	$0.81
Rate for Payer: Fidelis Medicare Advantage	$1.71
Rate for Payer: Group Health Inc Commercial	$0.81
Rate for Payer: Group Health Inc Medicare	$0.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.81
Rate for Payer: Hamaspik Choice Inc Medicare	$0.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.06

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$1.41

Service Code	NDC 72611075601
Hospital Charge Code	72611075601
Hospital Revenue Code	278
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.71
Rate for Payer: Hamaspik Choice Inc Medicare	$0.71

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$1.21

Service Code	NDC 67457022805
Hospital Charge Code	67457022805
Hospital Revenue Code	278
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.61
Rate for Payer: Hamaspik Choice Inc Medicare	$0.61

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$0.89

Service Code	NDC 00409955805
Hospital Charge Code	00409955805
Hospital Revenue Code	278
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.45
Rate for Payer: Aetna Government	$0.45
Rate for Payer: Brighton Health Commercial	$0.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.51
Rate for Payer: EmblemHealth Commercial	$0.45
Rate for Payer: Fidelis Medicare Advantage	$0.94
Rate for Payer: Group Health Inc Commercial	$0.45
Rate for Payer: Group Health Inc Medicare	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45
Rate for Payer: Hamaspik Choice Inc Medicare	$0.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.58

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$0.89

Service Code	NDC 43547053010
Hospital Charge Code	43547053010
Hospital Revenue Code	278
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45
Rate for Payer: Hamaspik Choice Inc Medicare	$0.45

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$0.89

Service Code	NDC 43547053001
Hospital Charge Code	43547053001
Hospital Revenue Code	278
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.45
Rate for Payer: Aetna Government	$0.45
Rate for Payer: Brighton Health Commercial	$0.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.51
Rate for Payer: EmblemHealth Commercial	$0.45
Rate for Payer: Fidelis Medicare Advantage	$0.94
Rate for Payer: Group Health Inc Commercial	$0.45
Rate for Payer: Group Health Inc Medicare	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45
Rate for Payer: Hamaspik Choice Inc Medicare	$0.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.58

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$1.41

Service Code	NDC 72611075610
Hospital Charge Code	72611075610
Hospital Revenue Code	278
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$1.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.71
Rate for Payer: Aetna Government	$0.71
Rate for Payer: Brighton Health Commercial	$0.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.81
Rate for Payer: EmblemHealth Commercial	$0.71
Rate for Payer: Fidelis Medicare Advantage	$1.48
Rate for Payer: Group Health Inc Commercial	$0.71
Rate for Payer: Group Health Inc Medicare	$0.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.71
Rate for Payer: Hamaspik Choice Inc Medicare	$0.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.92

ROCURONIUM BROMIDE 50 MG/5ML IV SOLN [95811]

Facility

$1.15

Service Code	NDC 66794022841
Hospital Charge Code	66794022841
Hospital Revenue Code	278
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58
Rate for Payer: Hamaspik Choice Inc Medicare	$0.58

Know your out-of-pocket cost for care.

All Charges