St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DESMOPRESSIN ACETATE 4 MCG/ML IJ SOLN

Facility

$63.00

Service Code	HCPCS J2597
Hospital Charge Code	7086045441
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$50.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.52
Rate for Payer: Aetna Government	$3.52
Rate for Payer: Affinity Essential Plan 1&2	$2.46
Rate for Payer: Affinity Essential Plan 3&4	$2.46
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.46
Rate for Payer: Brighton Health Commercial	$47.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.84
Rate for Payer: Elderplan Medicare Advantage	$3.52
Rate for Payer: EmblemHealth Commercial	$3.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.17
Rate for Payer: Fidelis Essential Plan Aliesa	$2.99
Rate for Payer: Fidelis Essential Plan QHP	$3.13
Rate for Payer: Fidelis Medicare Advantage	$3.52
Rate for Payer: Fidelis Qualified Health Plan	$3.13
Rate for Payer: Group Health Inc Commercial	$3.52
Rate for Payer: Group Health Inc Medicare	$3.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3.52
Rate for Payer: Healthfirst Medicare Advantage	$2.99
Rate for Payer: Healthfirst QHP	$3.52
Rate for Payer: Humana Medicare	$3.59
Rate for Payer: Senior Whole Health Medicare Advantage	$3.52
Rate for Payer: United Healthcare Medicare Advantage	$3.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$40.95
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.34
Rate for Payer: Wellcare Medicare	$3.34

DESMOPRESSIN ACETATE 4 MCG/ML IJ SOLN

Facility

$47.40

Service Code	HCPCS J2597
Hospital Charge Code	8363445141
Hospital Revenue Code	250
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.70

DESMOPRESSIN ACETATE 4 MCG/ML IJ SOLN

Facility

$63.00

Service Code	HCPCS J2597
Hospital Charge Code	7086045410
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$50.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.52
Rate for Payer: Aetna Government	$3.52
Rate for Payer: Affinity Essential Plan 1&2	$2.46
Rate for Payer: Affinity Essential Plan 3&4	$2.46
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.46
Rate for Payer: Brighton Health Commercial	$47.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.84
Rate for Payer: Elderplan Medicare Advantage	$3.52
Rate for Payer: EmblemHealth Commercial	$3.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.17
Rate for Payer: Fidelis Essential Plan Aliesa	$2.99
Rate for Payer: Fidelis Essential Plan QHP	$3.13
Rate for Payer: Fidelis Medicare Advantage	$3.52
Rate for Payer: Fidelis Qualified Health Plan	$3.13
Rate for Payer: Group Health Inc Commercial	$3.52
Rate for Payer: Group Health Inc Medicare	$3.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3.52
Rate for Payer: Healthfirst Medicare Advantage	$2.99
Rate for Payer: Healthfirst QHP	$3.52
Rate for Payer: Humana Medicare	$3.59
Rate for Payer: Senior Whole Health Medicare Advantage	$3.52
Rate for Payer: United Healthcare Medicare Advantage	$3.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$40.95
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.34
Rate for Payer: Wellcare Medicare	$3.34

DESMOPRESSIN ACETATE 4 MCG/ML IJ SOLN

Facility

$71.42

Service Code	HCPCS J2597
Hospital Charge Code	0703505103
Hospital Revenue Code	250
Min. Negotiated Rate	$35.71
Max. Negotiated Rate	$35.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.71

DESMOPRESSIN ACETATE 4 MCG/ML IJ SOLN

Facility

$71.42

Service Code	HCPCS J2597
Hospital Charge Code	6991890110
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$57.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.52
Rate for Payer: Aetna Government	$3.52
Rate for Payer: Affinity Essential Plan 1&2	$2.46
Rate for Payer: Affinity Essential Plan 3&4	$2.46
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.46
Rate for Payer: Brighton Health Commercial	$53.57
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.57
Rate for Payer: Elderplan Medicare Advantage	$3.52
Rate for Payer: EmblemHealth Commercial	$3.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.17
Rate for Payer: Fidelis Essential Plan Aliesa	$2.99
Rate for Payer: Fidelis Essential Plan QHP	$3.13
Rate for Payer: Fidelis Medicare Advantage	$3.52
Rate for Payer: Fidelis Qualified Health Plan	$3.13
Rate for Payer: Group Health Inc Commercial	$3.52
Rate for Payer: Group Health Inc Medicare	$3.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3.52
Rate for Payer: Healthfirst Medicare Advantage	$2.99
Rate for Payer: Healthfirst QHP	$3.52
Rate for Payer: Humana Medicare	$3.59
Rate for Payer: Senior Whole Health Medicare Advantage	$3.52
Rate for Payer: United Healthcare Medicare Advantage	$3.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.43
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.34
Rate for Payer: Wellcare Medicare	$3.34

DESMOPRESSIN ACETATE 4 MCG/ML IJ SOLN

Facility

$47.40

Service Code	HCPCS J2597
Hospital Charge Code	8363445110
Hospital Revenue Code	250
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.70

DESMOPRESSIN ACETATE 4 MCG/ML IJ SOLN

Facility

$71.32

Service Code	HCPCS J2597
Hospital Charge Code	6275652940
Hospital Revenue Code	250
Min. Negotiated Rate	$35.66
Max. Negotiated Rate	$35.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.66

DESMOPRESSIN ACETATE PF 4 MCG/ML IJ SOLN

Facility

$70.55

Service Code	HCPCS J2597
Hospital Charge Code	6991889901
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$56.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.52
Rate for Payer: Aetna Government	$3.52
Rate for Payer: Affinity Essential Plan 1&2	$2.46
Rate for Payer: Affinity Essential Plan 3&4	$2.46
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.46
Rate for Payer: Brighton Health Commercial	$52.91
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.98
Rate for Payer: Elderplan Medicare Advantage	$3.52
Rate for Payer: EmblemHealth Commercial	$3.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.17
Rate for Payer: Fidelis Essential Plan Aliesa	$2.99
Rate for Payer: Fidelis Essential Plan QHP	$3.13
Rate for Payer: Fidelis Medicare Advantage	$3.52
Rate for Payer: Fidelis Qualified Health Plan	$3.13
Rate for Payer: Group Health Inc Commercial	$3.52
Rate for Payer: Group Health Inc Medicare	$3.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3.52
Rate for Payer: Healthfirst Medicare Advantage	$2.99
Rate for Payer: Healthfirst QHP	$3.52
Rate for Payer: Humana Medicare	$3.59
Rate for Payer: Senior Whole Health Medicare Advantage	$3.52
Rate for Payer: United Healthcare Medicare Advantage	$3.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$45.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.34
Rate for Payer: Wellcare Medicare	$3.34

DESMOPRESSIN ACETATE PF 4 MCG/ML IJ SOLN

Facility

$70.55

Service Code	HCPCS J2597
Hospital Charge Code	6991889901
Hospital Revenue Code	250
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$35.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.28

DESMOPRESSIN ACETATE SPRAY 0.01 % NA SOLN

Facility

$49.25

Service Code	NDC 4733578891
Hospital Charge Code	4733578891
Hospital Revenue Code	250
Min. Negotiated Rate	$17.24
Max. Negotiated Rate	$39.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.62
Rate for Payer: Aetna Government	$24.62
Rate for Payer: Brighton Health Commercial	$36.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.49
Rate for Payer: EmblemHealth Commercial	$24.62
Rate for Payer: Group Health Inc Commercial	$24.62
Rate for Payer: Group Health Inc Medicare	$17.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.62
Rate for Payer: Hamaspik Choice Inc Medicare	$24.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.01

DESMOPRESSIN ACETATE SPRAY 0.01 % NA SOLN

Facility

$49.25

Service Code	NDC 6050508150
Hospital Charge Code	6050508150
Hospital Revenue Code	250
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$24.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.62

DESMOPRESSIN ACETATE SPRAY 0.01 % NA SOLN

Facility

$49.25

Service Code	NDC 6050508150
Hospital Charge Code	6050508150
Hospital Revenue Code	250
Min. Negotiated Rate	$17.24
Max. Negotiated Rate	$39.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.62
Rate for Payer: Aetna Government	$24.62
Rate for Payer: Brighton Health Commercial	$36.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.49
Rate for Payer: EmblemHealth Commercial	$24.62
Rate for Payer: Group Health Inc Commercial	$24.62
Rate for Payer: Group Health Inc Medicare	$17.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.62
Rate for Payer: Hamaspik Choice Inc Medicare	$24.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.01

DESMOPRESSIN ACETATE SPRAY 0.01 % NA SOLN

Facility

$49.25

Service Code	NDC 4733578891
Hospital Charge Code	4733578891
Hospital Revenue Code	250
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$24.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.62

DEVELOPMENTAL & NEUROPSYCHOLOGICAL TESTING

Facility

$263.83

Service Code	EAPG 00310
Min. Negotiated Rate	$192.09
Max. Negotiated Rate	$263.83
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$192.09
Rate for Payer: Healthfirst Commercial	$263.83

DEXAMETHASONE 0.5 MG/5ML PO SOLN

Facility

$0.27

Service Code	NDC 0054317757
Hospital Charge Code	0054317757
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$0.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.18
Rate for Payer: EmblemHealth Commercial	$0.13
Rate for Payer: Group Health Inc Commercial	$0.13
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.17

DEXAMETHASONE 0.5 MG/5ML PO SOLN

Facility

$0.27

Service Code	NDC 0054317757
Hospital Charge Code	0054317757
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13

DEXAMETHASONE 0.5 MG PO TABS

Facility

$0.21

Service Code	NDC 0054817925
Hospital Charge Code	0054817925
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10

DEXAMETHASONE 0.5 MG PO TABS

Facility

$0.21

Service Code	NDC 0054817925
Hospital Charge Code	0054817925
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Brighton Health Commercial	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: EmblemHealth Commercial	$0.10
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

DEXAMETHASONE 1 MG PO TABS

Facility

$0.30

Service Code	NDC 0054418125
Hospital Charge Code	0054418125
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15

DEXAMETHASONE 1 MG PO TABS

Facility

$0.37

Service Code	NDC 0054817425
Hospital Charge Code	0054817425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.19
Rate for Payer: Aetna Government	$0.19
Rate for Payer: Brighton Health Commercial	$0.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.25
Rate for Payer: EmblemHealth Commercial	$0.19
Rate for Payer: Group Health Inc Commercial	$0.19
Rate for Payer: Group Health Inc Medicare	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19
Rate for Payer: Hamaspik Choice Inc Medicare	$0.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.24

DEXAMETHASONE 1 MG PO TABS

Facility

$0.37

Service Code	NDC 0054817425
Hospital Charge Code	0054817425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19

DEXAMETHASONE 1 MG PO TABS

Facility

$0.30

Service Code	NDC 0054418125
Hospital Charge Code	0054418125
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.15
Rate for Payer: Aetna Government	$0.15
Rate for Payer: Brighton Health Commercial	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: EmblemHealth Commercial	$0.15
Rate for Payer: Group Health Inc Commercial	$0.15
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.19

DEXAMETHASONE 2 MG PO TABS

Facility

$0.50

Service Code	NDC 0904744461
Hospital Charge Code	0904744461
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.38
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	$0.18
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	$0.33

DEXAMETHASONE 2 MG PO TABS

Facility

$0.74

Service Code	NDC 0054817625
Hospital Charge Code	0054817625
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.37
Rate for Payer: Aetna Government	$0.37
Rate for Payer: Brighton Health Commercial	$0.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.50
Rate for Payer: EmblemHealth Commercial	$0.37
Rate for Payer: Group Health Inc Commercial	$0.37
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37
Rate for Payer: Hamaspik Choice Inc Medicare	$0.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.48

DEXAMETHASONE 2 MG PO TABS

Facility

$0.74

Service Code	NDC 0054817625
Hospital Charge Code	0054817625
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37

Know your out-of-pocket cost for care.

All Charges