St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

VENLAFAXINE HCL ER 150 MG PO CP24 [27859]

Facility

$4.57

Service Code	NDC 68084071311
Hospital Charge Code	68084071311
Hospital Revenue Code	250
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$3.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.29
Rate for Payer: Aetna Government	$2.29
Rate for Payer: Brighton Health Commercial	$3.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.11
Rate for Payer: Group Health Inc Commercial	$2.29
Rate for Payer: Group Health Inc Medicare	$1.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.29
Rate for Payer: Hamaspik Choice Inc Medicare	$2.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.97

VENLAFAXINE HCL ER 150 MG PO CP24 [27859]

Facility

$4.57

Service Code	NDC 68084071301
Hospital Charge Code	68084071301
Hospital Revenue Code	250
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$3.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.29
Rate for Payer: Aetna Government	$2.29
Rate for Payer: Brighton Health Commercial	$3.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.11
Rate for Payer: Group Health Inc Commercial	$2.29
Rate for Payer: Group Health Inc Medicare	$1.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.29
Rate for Payer: Hamaspik Choice Inc Medicare	$2.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.97

VENLAFAXINE HCL ER 37.5 MG PO CP24 [27857]

Facility

$4.16

Service Code	NDC 00093738498
Hospital Charge Code	00093738498
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$3.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.08
Rate for Payer: Aetna Government	$2.08
Rate for Payer: Brighton Health Commercial	$3.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.83
Rate for Payer: Group Health Inc Commercial	$2.08
Rate for Payer: Group Health Inc Medicare	$1.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.08
Rate for Payer: Hamaspik Choice Inc Medicare	$2.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.71

VENLAFAXINE HCL ER 37.5 MG PO CP24 [27857]

Facility

$4.16

Service Code	NDC 68382003416
Hospital Charge Code	68382003416
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$3.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.08
Rate for Payer: Aetna Government	$2.08
Rate for Payer: Brighton Health Commercial	$3.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.83
Rate for Payer: Group Health Inc Commercial	$2.08
Rate for Payer: Group Health Inc Medicare	$1.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.08
Rate for Payer: Hamaspik Choice Inc Medicare	$2.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.71

VENLAFAXINE HCL ER 37.5 MG PO CP24 [27857]

Facility

$0.62

Service Code	NDC 00904646861
Hospital Charge Code	00904646861
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.31
Rate for Payer: Aetna Government	$0.31
Rate for Payer: Brighton Health Commercial	$0.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.42
Rate for Payer: Group Health Inc Commercial	$0.31
Rate for Payer: Group Health Inc Medicare	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.40

VENLAFAXINE HCL ER 37.5 MG PO CP24 [27857]

Facility

$0.62

Service Code	NDC 00904707561
Hospital Charge Code	00904707561
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.31
Rate for Payer: Aetna Government	$0.31
Rate for Payer: Brighton Health Commercial	$0.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.42
Rate for Payer: Group Health Inc Commercial	$0.31
Rate for Payer: Group Health Inc Medicare	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.40

VENLAFAXINE HCL ER 75 MG PO CP24 [27858]

Facility

$4.67

Service Code	NDC 13668001990
Hospital Charge Code	13668001990
Hospital Revenue Code	250
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$3.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.34
Rate for Payer: Aetna Government	$2.34
Rate for Payer: Brighton Health Commercial	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.18
Rate for Payer: Group Health Inc Commercial	$2.34
Rate for Payer: Group Health Inc Medicare	$1.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.34
Rate for Payer: Hamaspik Choice Inc Medicare	$2.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.04

VENLAFAXINE HCL ER 75 MG PO CP24 [27858]

Facility

$4.67

Service Code	NDC 00093738556
Hospital Charge Code	00093738556
Hospital Revenue Code	250
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$3.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.33
Rate for Payer: Aetna Government	$2.33
Rate for Payer: Brighton Health Commercial	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.17
Rate for Payer: Group Health Inc Commercial	$2.33
Rate for Payer: Group Health Inc Medicare	$1.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.33
Rate for Payer: Hamaspik Choice Inc Medicare	$2.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.03

VENLAFAXINE HCL ER 75 MG PO CP24 [27858]

Facility

$4.67

Service Code	NDC 00093738598
Hospital Charge Code	00093738598
Hospital Revenue Code	250
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$3.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.33
Rate for Payer: Aetna Government	$2.33
Rate for Payer: Brighton Health Commercial	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.17
Rate for Payer: Group Health Inc Commercial	$2.33
Rate for Payer: Group Health Inc Medicare	$1.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.33
Rate for Payer: Hamaspik Choice Inc Medicare	$2.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.03

VENLAFAXINE HCL ER 75 MG PO CP24 [27858]

Facility

$4.67

Service Code	NDC 68382003516
Hospital Charge Code	68382003516
Hospital Revenue Code	250
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$3.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.33
Rate for Payer: Aetna Government	$2.33
Rate for Payer: Brighton Health Commercial	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.17
Rate for Payer: Group Health Inc Commercial	$2.33
Rate for Payer: Group Health Inc Medicare	$1.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.33
Rate for Payer: Hamaspik Choice Inc Medicare	$2.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.03

VENLAFAXINE SR 150 MG CAP CR

Facility

$0.57

Hospital Charge Code	41643063
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.29
Rate for Payer: Aetna Government	$0.29
Rate for Payer: Brighton Health Commercial	$0.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.39
Rate for Payer: Group Health Inc Commercial	$0.29
Rate for Payer: Group Health Inc Medicare	$0.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.29
Rate for Payer: Hamaspik Choice Inc Medicare	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.37

VENLAFAXINE SR 150 MG CAP CR

Facility

$0.57

Hospital Charge Code	41653063
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.29
Rate for Payer: Aetna Government	$0.29
Rate for Payer: Brighton Health Commercial	$0.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.39
Rate for Payer: Group Health Inc Commercial	$0.29
Rate for Payer: Group Health Inc Medicare	$0.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.29
Rate for Payer: Hamaspik Choice Inc Medicare	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.37

VENLAFAXINE SR 37.5 MG CAP CR

Facility

$0.46

Hospital Charge Code	41653061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Brighton Health Commercial	$0.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.30

VENLAFAXINE SR 37.5 MG CAP CR

Facility

$0.46

Hospital Charge Code	41643061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Brighton Health Commercial	$0.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.30

VENLAFAXINE SR 75 MG CAP CR

Facility

$0.54

Hospital Charge Code	41643062
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.27
Rate for Payer: Aetna Government	$0.27
Rate for Payer: Brighton Health Commercial	$0.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.37
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.35

VENLAFAXINE SR 75 MG CAP CR

Facility

$0.54

Hospital Charge Code	41653062
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.27
Rate for Payer: Aetna Government	$0.27
Rate for Payer: Brighton Health Commercial	$0.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.37
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.35

VENOGRAM CAVAL INFERIOR

Facility

$8,393.53

Service Code	HCPCS 75825 TC
Hospital Charge Code	41542598
Hospital Revenue Code	320
Min. Negotiated Rate	$2,937.74
Max. Negotiated Rate	$6,714.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,616.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,196.76
Rate for Payer: Aetna Government	$4,196.76
Rate for Payer: Brighton Health Commercial	$6,295.15
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,714.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,707.60
Rate for Payer: Group Health Inc Commercial	$4,196.76
Rate for Payer: Group Health Inc Medicare	$2,937.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$4,196.76

VENOGRAM CAVAL INFERIOR

Facility

$8,393.53

Service Code	HCPCS 75825 TC
Hospital Charge Code	41542598
Hospital Revenue Code	320
Rate for Payer: Cash Price	$3,686.08

VENOUS PRESSURE SET

Facility

$64.85

Hospital Charge Code	40206630
Hospital Revenue Code	270
Min. Negotiated Rate	$22.70
Max. Negotiated Rate	$51.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.42
Rate for Payer: Aetna Government	$32.42
Rate for Payer: Brighton Health Commercial	$48.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.10
Rate for Payer: Group Health Inc Commercial	$32.42
Rate for Payer: Group Health Inc Medicare	$22.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.42
Rate for Payer: Hamaspik Choice Inc Medicare	$32.42

VENTED TIP COVER

Facility

$0.85

Hospital Charge Code	64903603
Hospital Revenue Code	270
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.43
Rate for Payer: Aetna Government	$0.43
Rate for Payer: Brighton Health Commercial	$0.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.58
Rate for Payer: Group Health Inc Commercial	$0.43
Rate for Payer: Group Health Inc Medicare	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43
Rate for Payer: Hamaspik Choice Inc Medicare	$0.43

VENTILATOR TRANSPORT(IN HOUSE)

Facility

$421.00

Service Code	HCPCS 94799 TC
Hospital Charge Code	40301560
Hospital Revenue Code	460
Rate for Payer: Cash Price	$180.64

VENTILATOR TRANSPORT(IN HOUSE)

Facility

$421.00

Service Code	HCPCS 94799 TC
Hospital Charge Code	40301560
Hospital Revenue Code	460
Min. Negotiated Rate	$147.35
Max. Negotiated Rate	$336.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$210.50
Rate for Payer: Aetna Government	$210.50
Rate for Payer: Brighton Health Commercial	$315.75
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$336.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$286.28
Rate for Payer: Group Health Inc Commercial	$210.50
Rate for Payer: Group Health Inc Medicare	$147.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.50
Rate for Payer: Hamaspik Choice Inc Medicare	$210.50

VENTILATOR TRANSPORT(OUTSIDE)

Facility

$421.00

Service Code	HCPCS 94799 TC
Hospital Charge Code	40301570
Hospital Revenue Code	460
Rate for Payer: Cash Price	$180.64

VENTILATOR TRANSPORT(OUTSIDE)

Facility

$421.00

Service Code	HCPCS 94799 TC
Hospital Charge Code	40301570
Hospital Revenue Code	460
Min. Negotiated Rate	$147.35
Max. Negotiated Rate	$336.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$210.50
Rate for Payer: Aetna Government	$210.50
Rate for Payer: Brighton Health Commercial	$315.75
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$336.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$286.28
Rate for Payer: Group Health Inc Commercial	$210.50
Rate for Payer: Group Health Inc Medicare	$147.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.50
Rate for Payer: Hamaspik Choice Inc Medicare	$210.50

VENTI PAD

Facility

$62.37

Hospital Charge Code	40206660
Hospital Revenue Code	270
Min. Negotiated Rate	$21.83
Max. Negotiated Rate	$49.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.18
Rate for Payer: Aetna Government	$31.18
Rate for Payer: Brighton Health Commercial	$46.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$49.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.41
Rate for Payer: Group Health Inc Commercial	$31.18
Rate for Payer: Group Health Inc Medicare	$21.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.18
Rate for Payer: Hamaspik Choice Inc Medicare	$31.18

Know your out-of-pocket cost for care.

All Charges