St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ENOXAPARIN SODIUM 80 MG/0.8ML IJ SOSY

Facility

$27.94

Service Code	HCPCS J1650
Hospital Charge Code	7183911210
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$22.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Brighton Health Commercial	$20.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.00
Rate for Payer: EmblemHealth Commercial	$13.97
Rate for Payer: Group Health Inc Commercial	$13.97
Rate for Payer: Group Health Inc Medicare	$9.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.97
Rate for Payer: Hamaspik Choice Inc Medicare	$13.97
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.16

ENOXAPARIN SODIUM 80 MG/0.8ML IJ SOSY

Facility

$27.94

Service Code	HCPCS J1650
Hospital Charge Code	7183911210
Hospital Revenue Code	250
Min. Negotiated Rate	$13.97
Max. Negotiated Rate	$13.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.97

ENOXAPARIN SODIUM 80 MG/0.8ML IJ SOSY

Facility

$29.80

Service Code	HCPCS J1650
Hospital Charge Code	0075062280
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$23.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Brighton Health Commercial	$22.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.27
Rate for Payer: EmblemHealth Commercial	$14.90
Rate for Payer: Group Health Inc Commercial	$14.90
Rate for Payer: Group Health Inc Medicare	$10.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.90
Rate for Payer: Hamaspik Choice Inc Medicare	$14.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$19.37

ENOXAPARIN SODIUM 80 MG/0.8ML IJ SOSY

Facility

$29.80

Service Code	HCPCS J1650
Hospital Charge Code	0075062280
Hospital Revenue Code	250
Min. Negotiated Rate	$14.90
Max. Negotiated Rate	$14.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.90

ENOXAPARIN SODIUM 80 MG/0.8ML IJ SOSY

Facility

$11.10

Service Code	HCPCS J1650
Hospital Charge Code	6332358499
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$8.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Brighton Health Commercial	$8.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.55
Rate for Payer: EmblemHealth Commercial	$5.55
Rate for Payer: Group Health Inc Commercial	$5.55
Rate for Payer: Group Health Inc Medicare	$3.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.55
Rate for Payer: Hamaspik Choice Inc Medicare	$5.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.21

ENOXAPARIN SODIUM 80 MG/0.8ML IJ SOSY

Facility

$23.85

Service Code	HCPCS J1650
Hospital Charge Code	6332353190
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$19.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Brighton Health Commercial	$17.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.22
Rate for Payer: EmblemHealth Commercial	$11.93
Rate for Payer: Group Health Inc Commercial	$11.93
Rate for Payer: Group Health Inc Medicare	$8.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.93
Rate for Payer: Hamaspik Choice Inc Medicare	$11.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.50

ENOXAPARIN SODIUM 80 MG/0.8ML IJ SOSY

Facility

$23.85

Service Code	HCPCS J1650
Hospital Charge Code	6332353190
Hospital Revenue Code	250
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$11.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.93

ENTECAVIR 0.5 MG PO TABS

Facility

$44.44

Service Code	NDC 5199189533
Hospital Charge Code	5199189533
Hospital Revenue Code	250
Min. Negotiated Rate	$15.55
Max. Negotiated Rate	$35.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.22
Rate for Payer: Aetna Government	$22.22
Rate for Payer: Brighton Health Commercial	$33.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.22
Rate for Payer: EmblemHealth Commercial	$22.22
Rate for Payer: Group Health Inc Commercial	$22.22
Rate for Payer: Group Health Inc Medicare	$15.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.22
Rate for Payer: Hamaspik Choice Inc Medicare	$22.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.88

ENTECAVIR 0.5 MG PO TABS

Facility

$44.44

Service Code	NDC 5199189533
Hospital Charge Code	5199189533
Hospital Revenue Code	250
Min. Negotiated Rate	$22.22
Max. Negotiated Rate	$22.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.22

ENTECAVIR 0.5 MG PO TABS

Facility

$44.43

Service Code	NDC 3172283330
Hospital Charge Code	3172283330
Hospital Revenue Code	250
Min. Negotiated Rate	$15.55
Max. Negotiated Rate	$35.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.22
Rate for Payer: Aetna Government	$22.22
Rate for Payer: Brighton Health Commercial	$33.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.21
Rate for Payer: EmblemHealth Commercial	$22.22
Rate for Payer: Group Health Inc Commercial	$22.22
Rate for Payer: Group Health Inc Medicare	$15.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.22
Rate for Payer: Hamaspik Choice Inc Medicare	$22.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.88

ENTECAVIR 0.5 MG PO TABS

Facility

$44.43

Service Code	NDC 3172283330
Hospital Charge Code	3172283330
Hospital Revenue Code	250
Min. Negotiated Rate	$22.22
Max. Negotiated Rate	$22.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.22

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IJ SOLN

Facility

$18.00

Service Code	NDC 1478901401
Hospital Charge Code	1478901401
Hospital Revenue Code	250
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.00

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IJ SOLN

Facility

$18.00

Service Code	NDC 1478901401
Hospital Charge Code	1478901401
Hospital Revenue Code	250
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$14.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.00
Rate for Payer: Aetna Government	$9.00
Rate for Payer: Brighton Health Commercial	$13.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.24
Rate for Payer: EmblemHealth Commercial	$9.00
Rate for Payer: Group Health Inc Commercial	$9.00
Rate for Payer: Group Health Inc Medicare	$6.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.70

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$59.11

Service Code	HCPCS J3490
Hospital Charge Code	0781326971
Hospital Revenue Code	258
Min. Negotiated Rate	$20.69
Max. Negotiated Rate	$47.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.56
Rate for Payer: Aetna Government	$29.56
Rate for Payer: Brighton Health Commercial	$44.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.20
Rate for Payer: EmblemHealth Commercial	$29.56
Rate for Payer: Group Health Inc Commercial	$29.56
Rate for Payer: Group Health Inc Medicare	$20.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.56
Rate for Payer: Hamaspik Choice Inc Medicare	$29.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$38.42

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$34.85

Service Code	HCPCS J3490
Hospital Charge Code	4202321625
Hospital Revenue Code	258
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$17.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.42

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$56.75

Service Code	HCPCS J3490
Hospital Charge Code	7012116377
Hospital Revenue Code	258
Min. Negotiated Rate	$19.86
Max. Negotiated Rate	$45.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.37
Rate for Payer: Aetna Government	$28.37
Rate for Payer: Brighton Health Commercial	$42.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.59
Rate for Payer: EmblemHealth Commercial	$28.37
Rate for Payer: Group Health Inc Commercial	$28.37
Rate for Payer: Group Health Inc Medicare	$19.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.37
Rate for Payer: Hamaspik Choice Inc Medicare	$28.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.89

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$34.85

Service Code	HCPCS J3490
Hospital Charge Code	4202321601
Hospital Revenue Code	258
Min. Negotiated Rate	$12.20
Max. Negotiated Rate	$27.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Brighton Health Commercial	$26.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.70
Rate for Payer: EmblemHealth Commercial	$17.43
Rate for Payer: Group Health Inc Commercial	$17.43
Rate for Payer: Group Health Inc Medicare	$12.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.43
Rate for Payer: Hamaspik Choice Inc Medicare	$17.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.65

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$34.85

Service Code	HCPCS J3490
Hospital Charge Code	4202321601
Hospital Revenue Code	258
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$17.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.43

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$56.75

Service Code	HCPCS J3490
Hospital Charge Code	7012116377
Hospital Revenue Code	258
Min. Negotiated Rate	$28.37
Max. Negotiated Rate	$28.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.37

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$34.85

Service Code	HCPCS J3490
Hospital Charge Code	4202321683
Hospital Revenue Code	258
Min. Negotiated Rate	$12.20
Max. Negotiated Rate	$27.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.42
Rate for Payer: Aetna Government	$17.42
Rate for Payer: Brighton Health Commercial	$26.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.70
Rate for Payer: EmblemHealth Commercial	$17.42
Rate for Payer: Group Health Inc Commercial	$17.42
Rate for Payer: Group Health Inc Medicare	$12.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.42
Rate for Payer: Hamaspik Choice Inc Medicare	$17.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.65

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$30.01

Service Code	HCPCS J3490
Hospital Charge Code	7075661125
Hospital Revenue Code	258
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$24.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.01
Rate for Payer: Aetna Government	$15.01
Rate for Payer: Brighton Health Commercial	$22.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.41
Rate for Payer: EmblemHealth Commercial	$15.01
Rate for Payer: Group Health Inc Commercial	$15.01
Rate for Payer: Group Health Inc Medicare	$10.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.01
Rate for Payer: Hamaspik Choice Inc Medicare	$15.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$19.51

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$59.11

Service Code	HCPCS J3490
Hospital Charge Code	0781326971
Hospital Revenue Code	258
Min. Negotiated Rate	$29.56
Max. Negotiated Rate	$29.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.56

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$34.85

Service Code	HCPCS J3490
Hospital Charge Code	4202321625
Hospital Revenue Code	258
Min. Negotiated Rate	$12.20
Max. Negotiated Rate	$27.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.42
Rate for Payer: Aetna Government	$17.42
Rate for Payer: Brighton Health Commercial	$26.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.70
Rate for Payer: EmblemHealth Commercial	$17.42
Rate for Payer: Group Health Inc Commercial	$17.42
Rate for Payer: Group Health Inc Medicare	$12.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.42
Rate for Payer: Hamaspik Choice Inc Medicare	$17.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.65

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$34.85

Service Code	HCPCS J3490
Hospital Charge Code	4202321683
Hospital Revenue Code	258
Min. Negotiated Rate	$17.42
Max. Negotiated Rate	$17.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.42

EPHEDRINE SULFATE (PRESSORS) 50 MG/ML IV SOLN

Facility

$29.52

Service Code	HCPCS J3490
Hospital Charge Code	5515037301
Hospital Revenue Code	258
Min. Negotiated Rate	$10.33
Max. Negotiated Rate	$23.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.76
Rate for Payer: Aetna Government	$14.76
Rate for Payer: Brighton Health Commercial	$22.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.07
Rate for Payer: EmblemHealth Commercial	$14.76
Rate for Payer: Group Health Inc Commercial	$14.76
Rate for Payer: Group Health Inc Medicare	$10.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.76
Rate for Payer: Hamaspik Choice Inc Medicare	$14.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$19.19

Know your out-of-pocket cost for care.

All Charges