St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Diverticulitis & diverticulosis

Facility

$44,213.58

Service Code	APR-DRG 2442
Min. Negotiated Rate	$7,897.00
Max. Negotiated Rate	$44,213.58
Rate for Payer: Affinity Essential Plan 1&2	$44,213.58
Rate for Payer: Affinity Essential Plan 3&4	$44,213.58
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,650.48
Rate for Payer: Amida Care Medicaid	$19,650.48
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,213.58
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,650.48
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,650.48
Rate for Payer: Fidelis Qualified Health Plan	$23,580.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,650.48
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,650.48
Rate for Payer: Healthfirst Commercial	$13,359.00
Rate for Payer: Healthfirst Essential Plan	$44,213.58
Rate for Payer: Healthfirst QHP	$7,897.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,650.48
Rate for Payer: SOMOS Essential	$44,213.58
Rate for Payer: United Healthcare Essential Plan 1&2	$44,213.58
Rate for Payer: United Healthcare Essential Plan 3&4	$44,213.58
Rate for Payer: United Healthcare Medicaid	$19,650.48
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,650.48

Diverticulitis & diverticulosis

Facility

$52,448.02

Service Code	APR-DRG 2443
Min. Negotiated Rate	$11,589.00
Max. Negotiated Rate	$52,448.02
Rate for Payer: Affinity Essential Plan 1&2	$52,448.02
Rate for Payer: Affinity Essential Plan 3&4	$52,448.02
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,310.23
Rate for Payer: Amida Care Medicaid	$23,310.23
Rate for Payer: EmblemHealth Essential Plan 1&2	$52,448.02
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,310.23
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,310.23
Rate for Payer: Fidelis Qualified Health Plan	$27,972.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,310.23
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,310.23
Rate for Payer: Healthfirst Commercial	$20,937.00
Rate for Payer: Healthfirst Essential Plan	$52,448.02
Rate for Payer: Healthfirst QHP	$11,589.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,310.23
Rate for Payer: SOMOS Essential	$52,448.02
Rate for Payer: United Healthcare Essential Plan 1&2	$52,448.02
Rate for Payer: United Healthcare Essential Plan 3&4	$52,448.02
Rate for Payer: United Healthcare Medicaid	$23,310.23
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,310.23

DOBUTAMINE-DEXTROSE 1-5 MG/ML-% IV SOLN

Facility

$0.11

Service Code	HCPCS J1250
Hospital Charge Code	0338107302
Hospital Revenue Code	258
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$8.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: EmblemHealth Commercial	$0.05
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$7.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

DOBUTAMINE-DEXTROSE 1-5 MG/ML-% IV SOLN

Facility

$0.11

Service Code	HCPCS J1250
Hospital Charge Code	0338107302
Hospital Revenue Code	258
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05

DOBUTAMINE-DEXTROSE 4-5 MG/ML-% IV SOLN

Facility

$0.09

Service Code	NDC 0409372411
Hospital Charge Code	0409372411
Hospital Revenue Code	258
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04

DOBUTAMINE-DEXTROSE 4-5 MG/ML-% IV SOLN

Facility

$0.14

Service Code	NDC 0338107702
Hospital Charge Code	0338107702
Hospital Revenue Code	258
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

DOBUTAMINE-DEXTROSE 4-5 MG/ML-% IV SOLN

Facility

$0.14

Service Code	NDC 0338107702
Hospital Charge Code	0338107702
Hospital Revenue Code	258
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

DOBUTAMINE-DEXTROSE 4-5 MG/ML-% IV SOLN

Facility

$0.09

Service Code	NDC 0409372411
Hospital Charge Code	0409372411
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: EmblemHealth Commercial	$0.04
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.06

DOBUTAMINE HCL 12.5 MG/ML IV SOLN

Facility

$0.44

Service Code	HCPCS J1250
Hospital Charge Code	0409234401
Hospital Revenue Code	258
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$8.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$0.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.30
Rate for Payer: EmblemHealth Commercial	$0.22
Rate for Payer: Group Health Inc Commercial	$0.22
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$7.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

DOBUTAMINE HCL 12.5 MG/ML IV SOLN

Facility

$0.42

Service Code	HCPCS J1250
Hospital Charge Code	0409234402
Hospital Revenue Code	258
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21

DOBUTAMINE HCL 12.5 MG/ML IV SOLN

Facility

$0.44

Service Code	HCPCS J1250
Hospital Charge Code	0409234401
Hospital Revenue Code	258
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22

DOBUTAMINE HCL 12.5 MG/ML IV SOLN

Facility

$0.42

Service Code	HCPCS J1250
Hospital Charge Code	0409234402
Hospital Revenue Code	258
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$8.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$0.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.28
Rate for Payer: EmblemHealth Commercial	$0.21
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$7.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.27

DOBUTAMINE HCL 250 MG/20ML IV SOLN

Facility

$0.44

Service Code	HCPCS J1250
Hospital Charge Code	0409234401
Hospital Revenue Code	258
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$8.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$0.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.30
Rate for Payer: EmblemHealth Commercial	$0.22
Rate for Payer: Group Health Inc Commercial	$0.22
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$7.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

DOBUTAMINE HCL 250 MG/20ML IV SOLN

Facility

$0.42

Service Code	HCPCS J1250
Hospital Charge Code	0409234462
Hospital Revenue Code	258
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21

DOBUTAMINE HCL 250 MG/20ML IV SOLN

Facility

$0.42

Service Code	HCPCS J1250
Hospital Charge Code	0409234462
Hospital Revenue Code	258
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$8.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$0.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.28
Rate for Payer: EmblemHealth Commercial	$0.21
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$7.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.27

DOBUTAMINE HCL 250 MG/20ML IV SOLN

Facility

$0.44

Service Code	HCPCS J1250
Hospital Charge Code	0409234401
Hospital Revenue Code	258
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22

DOCETAXEL 160 MG/16ML IV SOLN

Facility

$37.76

Service Code	HCPCS J9171
Hospital Charge Code	0409020120
Hospital Revenue Code	258
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$30.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$28.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.68
Rate for Payer: EmblemHealth Commercial	$18.88
Rate for Payer: Group Health Inc Commercial	$18.88
Rate for Payer: Group Health Inc Medicare	$13.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.88
Rate for Payer: Hamaspik Choice Inc Medicare	$18.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$24.54

DOCETAXEL 160 MG/16ML IV SOLN

Facility

$37.76

Service Code	HCPCS J9171
Hospital Charge Code	0409020120
Hospital Revenue Code	258
Min. Negotiated Rate	$18.88
Max. Negotiated Rate	$18.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.88

DOCETAXEL 160 MG/8ML IV CONC

Facility

$365.15

Service Code	HCPCS J9171
Hospital Charge Code	6745778108
Hospital Revenue Code	258
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$292.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$200.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$273.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$292.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$248.30
Rate for Payer: EmblemHealth Commercial	$182.57
Rate for Payer: Group Health Inc Commercial	$182.57
Rate for Payer: Group Health Inc Medicare	$127.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$182.57
Rate for Payer: Hamaspik Choice Inc Medicare	$182.57
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$237.35

DOCETAXEL 160 MG/8ML IV CONC

Facility

$365.15

Service Code	HCPCS J9171
Hospital Charge Code	6745778108
Hospital Revenue Code	258
Min. Negotiated Rate	$182.57
Max. Negotiated Rate	$182.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$182.57

DOCETAXEL 20 MG/2ML IV SOLN

Facility

$41.25

Service Code	HCPCS J9171
Hospital Charge Code	6745753102
Hospital Revenue Code	258
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.62

DOCETAXEL 20 MG/2ML IV SOLN

Facility

$41.25

Service Code	HCPCS J9171
Hospital Charge Code	6745753102
Hospital Revenue Code	258
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$33.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$30.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.05
Rate for Payer: EmblemHealth Commercial	$20.62
Rate for Payer: Group Health Inc Commercial	$20.62
Rate for Payer: Group Health Inc Medicare	$14.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.62
Rate for Payer: Hamaspik Choice Inc Medicare	$20.62
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.81

DOCETAXEL 20 MG/ML IV CONC

Facility

$365.15

Service Code	HCPCS J9171
Hospital Charge Code	4733532340
Hospital Revenue Code	258
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$292.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$200.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$273.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$292.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$248.30
Rate for Payer: EmblemHealth Commercial	$182.57
Rate for Payer: Group Health Inc Commercial	$182.57
Rate for Payer: Group Health Inc Medicare	$127.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$182.57
Rate for Payer: Hamaspik Choice Inc Medicare	$182.57
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$237.35

DOCETAXEL 20 MG/ML IV CONC

Facility

$83.74

Service Code	HCPCS J9171
Hospital Charge Code	0409036601
Hospital Revenue Code	258
Min. Negotiated Rate	$41.87
Max. Negotiated Rate	$41.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.87

DOCETAXEL 20 MG/ML IV CONC

Facility

$83.74

Service Code	HCPCS J9171
Hospital Charge Code	0409036601
Hospital Revenue Code	258
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$66.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$62.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.94
Rate for Payer: EmblemHealth Commercial	$41.87
Rate for Payer: Group Health Inc Commercial	$41.87
Rate for Payer: Group Health Inc Medicare	$29.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.87
Rate for Payer: Hamaspik Choice Inc Medicare	$41.87
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$54.43

Know your out-of-pocket cost for care.

All Charges