St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ROOT PLANNING&SCALING-ENTIRE

Facility

$198.45

Hospital Charge Code	42300925
Hospital Revenue Code	361
Min. Negotiated Rate	$69.46
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$109.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$99.22
Rate for Payer: Aetna Government	$99.22
Rate for Payer: Brighton Health Commercial	$148.84
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: Group Health Inc Commercial	$99.22
Rate for Payer: Group Health Inc Medicare	$69.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$99.22
Rate for Payer: Hamaspik Choice Inc Medicare	$99.22

ROPINIROLE 0.25 MG TAB

Facility

$0.67

Hospital Charge Code	41645084
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.34
Rate for Payer: Aetna Government	$0.34
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.46
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.44

ROPINIROLE 0.25 MG TAB

Facility

$0.67

Hospital Charge Code	41655084
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.34
Rate for Payer: Aetna Government	$0.34
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.46
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.44

ROPINIROLE 0.25MG TAB

Facility

$1.00

Hospital Charge Code	41656033
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

ROPINIROLE 0.25MG TAB

Facility

$1.00

Hospital Charge Code	41646033
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

ROPINIROLE 1 MG TAB

Facility

$1.00

Hospital Charge Code	41643796
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

ROPINIROLE 1 MG TAB

Facility

$1.00

Hospital Charge Code	41653796
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

ROPINIROLE 1MG TAB

Facility

$1.00

Hospital Charge Code	41656034
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

ROPINIROLE 1MG TAB

Facility

$1.00

Hospital Charge Code	41646034
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

ROPINIROLE ER TB 6MG TABLET

Facility

$20.51

Hospital Charge Code	41650303
Hospital Revenue Code	250
Min. Negotiated Rate	$7.18
Max. Negotiated Rate	$16.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.26
Rate for Payer: Aetna Government	$10.26
Rate for Payer: Brighton Health Commercial	$15.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.95
Rate for Payer: Group Health Inc Commercial	$10.26
Rate for Payer: Group Health Inc Medicare	$7.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.26
Rate for Payer: Hamaspik Choice Inc Medicare	$10.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.33

ROPINIROLE ER TB 6MG TABLET

Facility

$20.51

Hospital Charge Code	41640303
Hospital Revenue Code	250
Min. Negotiated Rate	$7.18
Max. Negotiated Rate	$16.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.26
Rate for Payer: Aetna Government	$10.26
Rate for Payer: Brighton Health Commercial	$15.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.95
Rate for Payer: Group Health Inc Commercial	$10.26
Rate for Payer: Group Health Inc Medicare	$7.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.26
Rate for Payer: Hamaspik Choice Inc Medicare	$10.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.33

ROPINIROLE HCL 0.25 MG PO TABS [21688]

Facility

$0.59

Service Code	NDC 00904637361
Hospital Charge Code	00904637361
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.40
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.38

ROPINIROLE HCL 0.25 MG PO TABS [21688]

Facility

$2.50

Service Code	NDC 43547026810
Hospital Charge Code	43547026810
Hospital Revenue Code	250
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$2.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.25
Rate for Payer: Aetna Government	$1.25
Rate for Payer: Brighton Health Commercial	$1.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.70
Rate for Payer: Group Health Inc Commercial	$1.25
Rate for Payer: Group Health Inc Medicare	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.62

ROPINIROLE HCL 1 MG PO TABS [21689]

Facility

$2.51

Service Code	NDC 68462025501
Hospital Charge Code	68462025501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$2.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.25
Rate for Payer: Aetna Government	$1.25
Rate for Payer: Brighton Health Commercial	$1.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.70
Rate for Payer: Group Health Inc Commercial	$1.25
Rate for Payer: Group Health Inc Medicare	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.63

ROPINIROLE HCL ER 6 MG PO TB24 [97631]

Facility

$8.21

Service Code	NDC 55111072730
Hospital Charge Code	55111072730
Hospital Revenue Code	250
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$6.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.10
Rate for Payer: Aetna Government	$4.10
Rate for Payer: Brighton Health Commercial	$6.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.58
Rate for Payer: Group Health Inc Commercial	$4.10
Rate for Payer: Group Health Inc Medicare	$2.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.10
Rate for Payer: Hamaspik Choice Inc Medicare	$4.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.33

ROPIV 0.1%+FENT 250MCG NS 250ML

Facility

$24.00

Service Code	HCPCS J3490
Hospital Charge Code	41655945
Hospital Revenue Code	636
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$15.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.00
Rate for Payer: Aetna Government	$12.00
Rate for Payer: Brighton Health Commercial	$14.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.80
Rate for Payer: Group Health Inc Commercial	$12.00
Rate for Payer: Group Health Inc Medicare	$8.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.60

ROPIV 0.1%+FENT 250MCG NS 250ML

Facility

$24.00

Service Code	HCPCS J3490
Hospital Charge Code	41655945
Hospital Revenue Code	636
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12.00

ROPIV 0.1%+FENT 250MCG NS 250ML

Facility

$24.00

Service Code	HCPCS J3490
Hospital Charge Code	41645945
Hospital Revenue Code	636
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12.00

ROPIV 0.1%+FENT 250MCG NS 250ML

Facility

$24.00

Service Code	HCPCS J3490
Hospital Charge Code	41645945
Hospital Revenue Code	636
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$15.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.00
Rate for Payer: Aetna Government	$12.00
Rate for Payer: Brighton Health Commercial	$14.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.80
Rate for Payer: Group Health Inc Commercial	$12.00
Rate for Payer: Group Health Inc Medicare	$8.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.60

ROPIVACAINE

Facility

$0.41

Service Code	HCPCS J2795
Hospital Charge Code	41640263
Hospital Revenue Code	636
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21

ROPIVACAINE

Facility

$0.41

Service Code	HCPCS J2795
Hospital Charge Code	41650263
Hospital Revenue Code	636
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$0.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
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	$0.27

ROPIVACAINE

Facility

$0.41

Service Code	HCPCS J2795
Hospital Charge Code	41640263
Hospital Revenue Code	636
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$0.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
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	$0.27

ROPIVACAINE

Facility

$0.41

Service Code	HCPCS J2795
Hospital Charge Code	41650263
Hospital Revenue Code	636
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21

ROPIVACAINE 0.1% + FENTANYL 1 MCG/ML EPI

Facility

$40.00

Service Code	HCPCS J3490
Hospital Charge Code	41645457
Hospital Revenue Code	636
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$26.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.00
Rate for Payer: Aetna Government	$20.00
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.00
Rate for Payer: Group Health Inc Commercial	$20.00
Rate for Payer: Group Health Inc Medicare	$14.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.00
Rate for Payer: Hamaspik Choice Inc Medicare	$20.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.00

ROPIVACAINE 0.1% + FENTANYL 1 MCG/ML EPI

Facility

$40.00

Hospital Charge Code	41655457
Hospital Revenue Code	250
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$32.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.00
Rate for Payer: Aetna Government	$20.00
Rate for Payer: Brighton Health Commercial	$30.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.20
Rate for Payer: Group Health Inc Commercial	$20.00
Rate for Payer: Group Health Inc Medicare	$14.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.00
Rate for Payer: Hamaspik Choice Inc Medicare	$20.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.00

Know your out-of-pocket cost for care.

All Charges