St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ERIBULIN MESYLATE 1 MG/2ML IV SOLN

Facility

$846.00

Service Code	HCPCS J9179
Hospital Charge Code	6285638901
Hospital Revenue Code	258
Min. Negotiated Rate	$75.94
Max. Negotiated Rate	$10,295.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$465.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$89.34
Rate for Payer: Aetna Government	$89.34
Rate for Payer: Affinity Essential Plan 1&2	$231.64
Rate for Payer: Affinity Essential Plan 3&4	$231.64
Rate for Payer: Affinity Medicaid/CHP/HARP	$102.95
Rate for Payer: Amida Care Medicaid	$102.95
Rate for Payer: Brighton Health Commercial	$634.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$89.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$676.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$575.28
Rate for Payer: Elderplan Medicare Advantage	$89.34
Rate for Payer: EmblemHealth Commercial	$89.34
Rate for Payer: EmblemHealth Essential Plan 1&2	$231.64
Rate for Payer: EmblemHealth Essential Plan 3&4	$102.95
Rate for Payer: Fidelis CHP/HARP/Medicaid	$102.95
Rate for Payer: Fidelis Essential Plan Aliesa	$231.64
Rate for Payer: Fidelis Essential Plan QHP	$231.64
Rate for Payer: Fidelis Medicare Advantage	$89.34
Rate for Payer: Fidelis Qualified Health Plan	$108.10
Rate for Payer: Group Health Inc Commercial	$89.34
Rate for Payer: Group Health Inc Medicare	$89.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.95
Rate for Payer: Hamaspik Choice Inc Medicare	$89.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$10,295.00
Rate for Payer: Healthfirst Essential Plan	$231.64
Rate for Payer: Healthfirst Medicare Advantage	$75.94
Rate for Payer: Healthfirst QHP	$167.81
Rate for Payer: Humana Medicare	$91.13
Rate for Payer: Senior Whole Health Medicare Advantage	$89.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$102.95
Rate for Payer: SOMOS Essential	$231.64
Rate for Payer: United Healthcare Essential Plan 1&2	$231.64
Rate for Payer: United Healthcare Essential Plan 3&4	$113.25
Rate for Payer: United Healthcare Medicaid	$102.95
Rate for Payer: United Healthcare Medicare Advantage	$89.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$549.90
Rate for Payer: Wellcare CHP/FHP/Medicaid	$102.95
Rate for Payer: Wellcare Medicare	$84.87

ERIBULIN MESYLATE 1 MG/2ML IV SOLN

Facility

$846.00

Service Code	HCPCS J9179
Hospital Charge Code	6285638901
Hospital Revenue Code	258
Min. Negotiated Rate	$423.00
Max. Negotiated Rate	$423.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.00

ERTAPENEM 312.5 MG/ML IN LIDOCAINE 1% IM INJ-COMPOUNDED

Facility

$22.50

Service Code	HCPCS J1335
Hospital Charge Code	9999700525
Hospital Revenue Code	250
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$28.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.24
Rate for Payer: Aetna Government	$28.24
Rate for Payer: Brighton Health Commercial	$16.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.30
Rate for Payer: EmblemHealth Commercial	$11.25
Rate for Payer: Group Health Inc Commercial	$11.25
Rate for Payer: Group Health Inc Medicare	$7.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.25
Rate for Payer: Hamaspik Choice Inc Medicare	$11.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.62

ERTAPENEM 312.5 MG/ML IN LIDOCAINE 1% IM INJ-COMPOUNDED

Facility

$22.50

Service Code	HCPCS J1335
Hospital Charge Code	9999700525
Hospital Revenue Code	250
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.25

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$140.48

Service Code	HCPCS J1335
Hospital Charge Code	4202322110
Hospital Revenue Code	250
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$112.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.24
Rate for Payer: Aetna Government	$28.24
Rate for Payer: Brighton Health Commercial	$105.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.53
Rate for Payer: EmblemHealth Commercial	$70.24
Rate for Payer: Group Health Inc Commercial	$70.24
Rate for Payer: Group Health Inc Medicare	$49.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.24
Rate for Payer: Hamaspik Choice Inc Medicare	$70.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.31

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$72.00

Service Code	HCPCS J1335
Hospital Charge Code	5515028220
Hospital Revenue Code	250
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$57.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.24
Rate for Payer: Aetna Government	$28.24
Rate for Payer: Brighton Health Commercial	$54.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.96
Rate for Payer: EmblemHealth Commercial	$36.00
Rate for Payer: Group Health Inc Commercial	$36.00
Rate for Payer: Group Health Inc Medicare	$25.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.00
Rate for Payer: Hamaspik Choice Inc Medicare	$36.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.80

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$120.00

Service Code	HCPCS J1335
Hospital Charge Code	4359890111
Hospital Revenue Code	250
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$72.00

Service Code	HCPCS J1335
Hospital Charge Code	5515028220
Hospital Revenue Code	250
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.00

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$140.48

Service Code	HCPCS J1335
Hospital Charge Code	4202322110
Hospital Revenue Code	250
Min. Negotiated Rate	$70.24
Max. Negotiated Rate	$70.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.24

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$140.48

Service Code	HCPCS J1335
Hospital Charge Code	6050561960
Hospital Revenue Code	250
Min. Negotiated Rate	$70.24
Max. Negotiated Rate	$70.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.24

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$140.48

Service Code	HCPCS J1335
Hospital Charge Code	6050561960
Hospital Revenue Code	250
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$112.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.24
Rate for Payer: Aetna Government	$28.24
Rate for Payer: Brighton Health Commercial	$105.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.53
Rate for Payer: EmblemHealth Commercial	$70.24
Rate for Payer: Group Health Inc Commercial	$70.24
Rate for Payer: Group Health Inc Medicare	$49.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.24
Rate for Payer: Hamaspik Choice Inc Medicare	$70.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.31

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$120.00

Service Code	HCPCS J1335
Hospital Charge Code	4359890111
Hospital Revenue Code	250
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$96.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.24
Rate for Payer: Aetna Government	$28.24
Rate for Payer: Brighton Health Commercial	$90.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$96.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.60
Rate for Payer: EmblemHealth Commercial	$60.00
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.00

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$140.48

Service Code	HCPCS J1335
Hospital Charge Code	4202322101
Hospital Revenue Code	250
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$112.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.24
Rate for Payer: Aetna Government	$28.24
Rate for Payer: Brighton Health Commercial	$105.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.53
Rate for Payer: EmblemHealth Commercial	$70.24
Rate for Payer: Group Health Inc Commercial	$70.24
Rate for Payer: Group Health Inc Medicare	$49.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.24
Rate for Payer: Hamaspik Choice Inc Medicare	$70.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.31

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$140.48

Service Code	HCPCS J1335
Hospital Charge Code	4202322101
Hospital Revenue Code	250
Min. Negotiated Rate	$70.24
Max. Negotiated Rate	$70.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.24

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$140.48

Service Code	HCPCS J1335
Hospital Charge Code	6050561964
Hospital Revenue Code	250
Min. Negotiated Rate	$70.24
Max. Negotiated Rate	$70.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.24

ERTAPENEM SODIUM 1 G IJ SOLR

Facility

$140.48

Service Code	HCPCS J1335
Hospital Charge Code	6050561964
Hospital Revenue Code	250
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$112.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.24
Rate for Payer: Aetna Government	$28.24
Rate for Payer: Brighton Health Commercial	$105.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.53
Rate for Payer: EmblemHealth Commercial	$70.24
Rate for Payer: Group Health Inc Commercial	$70.24
Rate for Payer: Group Health Inc Medicare	$49.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.24
Rate for Payer: Hamaspik Choice Inc Medicare	$70.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.31

ERYTHROMYCIN 2 % EX SOLN

Facility

$0.83

Service Code	NDC 4580203846
Hospital Charge Code	4580203846
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Brighton Health Commercial	$0.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: EmblemHealth Commercial	$0.42
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.54

ERYTHROMYCIN 2 % EX SOLN

Facility

$0.83

Service Code	NDC 4580203846
Hospital Charge Code	4580203846
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42

ERYTHROMYCIN 2 % EX SOLN

Facility

$0.83

Service Code	NDC 4257138425
Hospital Charge Code	4257138425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42

ERYTHROMYCIN 2 % EX SOLN

Facility

$0.83

Service Code	NDC 4257138425
Hospital Charge Code	4257138425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Brighton Health Commercial	$0.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: EmblemHealth Commercial	$0.42
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.54

ERYTHROMYCIN 5 MG/GM OP OINT

Facility

$8.27

Service Code	NDC 7248567035
Hospital Charge Code	7248567035
Hospital Revenue Code	250
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$6.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.14
Rate for Payer: Aetna Government	$4.14
Rate for Payer: Brighton Health Commercial	$6.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.62
Rate for Payer: EmblemHealth Commercial	$4.14
Rate for Payer: Group Health Inc Commercial	$4.14
Rate for Payer: Group Health Inc Medicare	$2.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.14
Rate for Payer: Hamaspik Choice Inc Medicare	$4.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.38

ERYTHROMYCIN 5 MG/GM OP OINT

Facility

$5.13

Service Code	NDC 0574402435
Hospital Charge Code	0574402435
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$4.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.57
Rate for Payer: Aetna Government	$2.57
Rate for Payer: Brighton Health Commercial	$3.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.49
Rate for Payer: EmblemHealth Commercial	$2.57
Rate for Payer: Group Health Inc Commercial	$2.57
Rate for Payer: Group Health Inc Medicare	$1.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.57
Rate for Payer: Hamaspik Choice Inc Medicare	$2.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.34

ERYTHROMYCIN 5 MG/GM OP OINT

Facility

$12.42

Service Code	NDC 2420891019
Hospital Charge Code	2420891019
Hospital Revenue Code	250
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$9.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.21
Rate for Payer: Aetna Government	$6.21
Rate for Payer: Brighton Health Commercial	$9.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.44
Rate for Payer: EmblemHealth Commercial	$6.21
Rate for Payer: Group Health Inc Commercial	$6.21
Rate for Payer: Group Health Inc Medicare	$4.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.21
Rate for Payer: Hamaspik Choice Inc Medicare	$6.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.07

ERYTHROMYCIN 5 MG/GM OP OINT

Facility

$8.27

Service Code	NDC 7248567035
Hospital Charge Code	7248567035
Hospital Revenue Code	250
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$4.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.14

ERYTHROMYCIN 5 MG/GM OP OINT

Facility

$20.04

Service Code	NDC 7248567031
Hospital Charge Code	7248567031
Hospital Revenue Code	250
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$16.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.02
Rate for Payer: Aetna Government	$10.02
Rate for Payer: Brighton Health Commercial	$15.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.62
Rate for Payer: EmblemHealth Commercial	$10.02
Rate for Payer: Group Health Inc Commercial	$10.02
Rate for Payer: Group Health Inc Medicare	$7.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.02
Rate for Payer: Hamaspik Choice Inc Medicare	$10.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.02

Know your out-of-pocket cost for care.

All Charges