St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

VESTIBULOPLASTY-(INC GRAFTS, HYPE

Facility

$1,000.00

Service Code	HCPCS D7350
Hospital Charge Code	42301750
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,772.21

VESTIBULOPLASTY-RIDGE EXTENSION (

Facility

$750.00

Service Code	HCPCS D7340
Hospital Charge Code	42301745
Hospital Revenue Code	361
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$6,772.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$412.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,772.21
Rate for Payer: Aetna Government	$6,772.21
Rate for Payer: Brighton Health Commercial	$562.50
Rate for Payer: Cash Price	$6,772.21
Rate for Payer: Cash Price	$6,772.21
Rate for Payer: Cash Price	$6,772.21
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,772.21
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: Elderplan Medicare Advantage	$6,772.21
Rate for Payer: EmblemHealth Commercial	$6,772.21
Rate for Payer: Fidelis Essential Plan Aliesa	$5,756.38
Rate for Payer: Fidelis Essential Plan QHP	$6,027.27
Rate for Payer: Fidelis Medicare Advantage	$6,772.21
Rate for Payer: Fidelis Qualified Health Plan	$6,027.27
Rate for Payer: Group Health Inc Commercial	$6,772.21
Rate for Payer: Group Health Inc Medicare	$6,772.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$375.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,772.21
Rate for Payer: Healthfirst Medicare Advantage	$5,756.38
Rate for Payer: Healthfirst QHP	$6,772.21
Rate for Payer: Senior Whole Health Medicare Advantage	$6,772.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,772.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5,417.77
Rate for Payer: Wellcare Medicare	$6,433.60

VESTIBULOPLASTY-RIDGE EXTENSION (

Facility

$750.00

Service Code	HCPCS D7340
Hospital Charge Code	42301745
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,772.21

VEST RESTRAINT

Facility

$37.57

Hospital Charge Code	40207594
Hospital Revenue Code	270
Min. Negotiated Rate	$13.15
Max. Negotiated Rate	$30.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.78
Rate for Payer: Aetna Government	$18.78
Rate for Payer: Brighton Health Commercial	$28.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.55
Rate for Payer: Group Health Inc Commercial	$18.78
Rate for Payer: Group Health Inc Medicare	$13.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.78
Rate for Payer: Hamaspik Choice Inc Medicare	$18.78

VFC SELF PAY ADMIN OF VACCINE

Facility

$0.01

Service Code	HCPCS 90460
Hospital Charge Code	30304100
Hospital Revenue Code	771
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.00
Rate for Payer: Aetna Government	$10.00
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

VFC SELF PAY VACCINE

Facility

$0.01

Hospital Charge Code	30304101
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

VFC S/P INADM ANY ADDL VAC/TOX

Facility

$0.01

Service Code	HCPCS 90461
Hospital Charge Code	30103361
Hospital Revenue Code	771
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.00
Rate for Payer: Aetna Government	$5.00
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

VIAL2BAG

Facility

$6.00

Hospital Charge Code	64902186
Hospital Revenue Code	270
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Brighton Health Commercial	$4.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00

VIAL2BAG DC BLUE

Facility

$5.71

Hospital Charge Code	64902120
Hospital Revenue Code	270
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$4.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.86
Rate for Payer: Aetna Government	$2.86
Rate for Payer: Brighton Health Commercial	$4.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.88
Rate for Payer: Group Health Inc Commercial	$2.86
Rate for Payer: Group Health Inc Medicare	$2.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.86
Rate for Payer: Hamaspik Choice Inc Medicare	$2.86

VIAL2BAG DC BLUE 20MM

Facility

$4.88

Hospital Charge Code	64902180
Hospital Revenue Code	270
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$3.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.44
Rate for Payer: Aetna Government	$2.44
Rate for Payer: Brighton Health Commercial	$3.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.32
Rate for Payer: Group Health Inc Commercial	$2.44
Rate for Payer: Group Health Inc Medicare	$1.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.44
Rate for Payer: Hamaspik Choice Inc Medicare	$2.44

VIAL2BAG DC ORANGE 13MM

Facility

$4.88

Hospital Charge Code	64902178
Hospital Revenue Code	270
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$3.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.44
Rate for Payer: Aetna Government	$2.44
Rate for Payer: Brighton Health Commercial	$3.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.32
Rate for Payer: Group Health Inc Commercial	$2.44
Rate for Payer: Group Health Inc Medicare	$1.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.44
Rate for Payer: Hamaspik Choice Inc Medicare	$2.44

VIAL2BAG ORANGE 13MM

Facility

$285.46

Hospital Charge Code	64902115
Hospital Revenue Code	270
Min. Negotiated Rate	$99.91
Max. Negotiated Rate	$228.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$142.73
Rate for Payer: Aetna Government	$142.73
Rate for Payer: Brighton Health Commercial	$214.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$228.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$194.11
Rate for Payer: Group Health Inc Commercial	$142.73
Rate for Payer: Group Health Inc Medicare	$99.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.73
Rate for Payer: Hamaspik Choice Inc Medicare	$142.73

VIAL 2 BAG PROG

Facility

$6.22

Hospital Charge Code	64901571
Hospital Revenue Code	270
Min. Negotiated Rate	$2.18
Max. Negotiated Rate	$4.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.11
Rate for Payer: Aetna Government	$3.11
Rate for Payer: Brighton Health Commercial	$4.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.23
Rate for Payer: Group Health Inc Commercial	$3.11
Rate for Payer: Group Health Inc Medicare	$2.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.11
Rate for Payer: Hamaspik Choice Inc Medicare	$3.11

VIDEO/SPEECH EVAL

Facility

$705.83

Service Code	HCPCS 70371 TC
Hospital Charge Code	30304096
Hospital Revenue Code	320
Rate for Payer: Cash Price	$283.37

VIDEO/SPEECH EVAL

Facility

$705.83

Service Code	HCPCS 70371 TC
Hospital Charge Code	30304096
Hospital Revenue Code	320
Min. Negotiated Rate	$247.04
Max. Negotiated Rate	$564.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$388.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$352.92
Rate for Payer: Aetna Government	$352.92
Rate for Payer: Brighton Health Commercial	$529.37
Rate for Payer: Cash Price	$283.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$564.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$479.96
Rate for Payer: Group Health Inc Commercial	$352.92
Rate for Payer: Group Health Inc Medicare	$247.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.92
Rate for Payer: Hamaspik Choice Inc Medicare	$352.92

VINBLASTINE 10 MG INJ

Facility

$1.96

Service Code	HCPCS J9360
Hospital Charge Code	41652886
Hospital Revenue Code	636
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$5.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.35
Rate for Payer: Aetna Government	$3.35
Rate for Payer: Brighton Health Commercial	$1.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.13
Rate for Payer: Group Health Inc Commercial	$0.98
Rate for Payer: Group Health Inc Medicare	$0.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.98
Rate for Payer: Hamaspik Choice Inc Medicare	$0.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5.32
Rate for Payer: SOMOS Essential	$5.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.27

VINBLASTINE 10 MG INJ

Facility

$1.96

Service Code	HCPCS J9360
Hospital Charge Code	41642886
Hospital Revenue Code	636
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$5.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.35
Rate for Payer: Aetna Government	$3.35
Rate for Payer: Brighton Health Commercial	$1.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.13
Rate for Payer: Group Health Inc Commercial	$0.98
Rate for Payer: Group Health Inc Medicare	$0.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.98
Rate for Payer: Hamaspik Choice Inc Medicare	$0.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5.32
Rate for Payer: SOMOS Essential	$5.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.27

VINBLASTINE 10 MG INJ

Facility

$1.96

Service Code	HCPCS J9360
Hospital Charge Code	41652886
Hospital Revenue Code	636
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.98
Rate for Payer: Hamaspik Choice Inc Medicare	$0.98

VINBLASTINE 10 MG INJ

Facility

$1.96

Service Code	HCPCS J9360
Hospital Charge Code	41642886
Hospital Revenue Code	636
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.98
Rate for Payer: Hamaspik Choice Inc Medicare	$0.98

VINBLASTINE SULFATE 1 MG/ML IV SOLN [8594]

Facility

$6.45

Service Code	HCPCS J9360
Hospital Charge Code	63323027810
Hospital Revenue Code	278
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$3.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.23
Rate for Payer: Hamaspik Choice Inc Medicare	$3.23

VINBLASTINE SULFATE 1 MG/ML IV SOLN [8594]

Facility

$6.45

Service Code	HCPCS J9360
Hospital Charge Code	63323027810
Hospital Revenue Code	278
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$6.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.35
Rate for Payer: Aetna Government	$3.35
Rate for Payer: Brighton Health Commercial	$3.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.71
Rate for Payer: EmblemHealth Commercial	$3.23
Rate for Payer: Fidelis Medicare Advantage	$6.77
Rate for Payer: Group Health Inc Commercial	$3.23
Rate for Payer: Group Health Inc Medicare	$2.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.23
Rate for Payer: Hamaspik Choice Inc Medicare	$3.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.19

VINCRISTINE 1 MG/ML INJ 1 ML

Facility

$6.11

Service Code	HCPCS J9370
Hospital Charge Code	41654133
Hospital Revenue Code	636
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$8.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.03
Rate for Payer: Aetna Government	$5.03
Rate for Payer: Brighton Health Commercial	$3.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.51
Rate for Payer: Group Health Inc Commercial	$3.06
Rate for Payer: Group Health Inc Medicare	$2.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.06
Rate for Payer: Hamaspik Choice Inc Medicare	$3.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.39
Rate for Payer: SOMOS Essential	$8.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.97

VINCRISTINE 1 MG/ML INJ 1 ML

Facility

$6.11

Service Code	HCPCS J9370
Hospital Charge Code	41644133
Hospital Revenue Code	636
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.06
Rate for Payer: Hamaspik Choice Inc Medicare	$3.06

VINCRISTINE 1 MG/ML INJ 1 ML

Facility

$6.11

Service Code	HCPCS J9370
Hospital Charge Code	41654133
Hospital Revenue Code	636
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.06
Rate for Payer: Hamaspik Choice Inc Medicare	$3.06

VINCRISTINE 1 MG/ML INJ 1 ML

Facility

$6.11

Service Code	HCPCS J9370
Hospital Charge Code	41644133
Hospital Revenue Code	636
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$8.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.03
Rate for Payer: Aetna Government	$5.03
Rate for Payer: Brighton Health Commercial	$3.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.51
Rate for Payer: Group Health Inc Commercial	$3.06
Rate for Payer: Group Health Inc Medicare	$2.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.06
Rate for Payer: Hamaspik Choice Inc Medicare	$3.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.39
Rate for Payer: SOMOS Essential	$8.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.97

Know your out-of-pocket cost for care.

All Charges