St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ETOMIDATE 2 MG/ML IV SOLN

Facility

$0.53

Service Code	NDC 7226614610
Hospital Charge Code	7226614610
Hospital Revenue Code	258
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27

ETOMIDATE 2 MG/ML IV SOLN

Facility

$0.39

Service Code	NDC 7248550901
Hospital Charge Code	7248550901
Hospital Revenue Code	258
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.20
Rate for Payer: Aetna Government	$0.20
Rate for Payer: Brighton Health Commercial	$0.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.27
Rate for Payer: EmblemHealth Commercial	$0.20
Rate for Payer: Group Health Inc Commercial	$0.20
Rate for Payer: Group Health Inc Medicare	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20
Rate for Payer: Hamaspik Choice Inc Medicare	$0.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.26

ETOMIDATE 2 MG/ML IV SOLN

Facility

$1.18

Service Code	NDC 6745790210
Hospital Charge Code	6745790210
Hospital Revenue Code	258
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$0.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.59

ETOMIDATE 2 MG/ML IV SOLN

Facility

$0.29

Service Code	NDC 7226614701
Hospital Charge Code	7226614701
Hospital Revenue Code	258
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.15
Rate for Payer: Aetna Government	$0.15
Rate for Payer: Brighton Health Commercial	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: EmblemHealth Commercial	$0.15
Rate for Payer: Group Health Inc Commercial	$0.15
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.19

ETOMIDATE 2 MG/ML IV SOLN

Facility

$0.29

Service Code	NDC 7226614701
Hospital Charge Code	7226614701
Hospital Revenue Code	258
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15

ETOMIDATE 2 MG/ML IV SOLN

Facility

$1.18

Service Code	NDC 6745790200
Hospital Charge Code	6745790200
Hospital Revenue Code	258
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.59
Rate for Payer: Aetna Government	$0.59
Rate for Payer: Brighton Health Commercial	$0.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.80
Rate for Payer: EmblemHealth Commercial	$0.59
Rate for Payer: Group Health Inc Commercial	$0.59
Rate for Payer: Group Health Inc Medicare	$0.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.59
Rate for Payer: Hamaspik Choice Inc Medicare	$0.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.77

ETOMIDATE 2 MG/ML IV SOLN

Facility

$0.68

Service Code	NDC 0409669511
Hospital Charge Code	0409669511
Hospital Revenue Code	258
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34

ETOMIDATE 2 MG/ML IV SOLN

Facility

$1.18

Service Code	NDC 6745790210
Hospital Charge Code	6745790210
Hospital Revenue Code	258
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.59
Rate for Payer: Aetna Government	$0.59
Rate for Payer: Brighton Health Commercial	$0.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.80
Rate for Payer: EmblemHealth Commercial	$0.59
Rate for Payer: Group Health Inc Commercial	$0.59
Rate for Payer: Group Health Inc Medicare	$0.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.59
Rate for Payer: Hamaspik Choice Inc Medicare	$0.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.77

ETONOGESTREL 68 MG SC IMPL

Facility

$1.00

Service Code	HCPCS J7307
Hospital Charge Code	7820614501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$0.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50

ETONOGESTREL 68 MG SC IMPL

Facility

$1.00

Service Code	HCPCS J7307
Hospital Charge Code	7820614501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$1,030.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,030.64
Rate for Payer: Aetna Government	$1,030.64
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: EmblemHealth Commercial	$0.50
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

ETOPOSIDE 100 MG/5ML IV SOLN

Facility

$2.25

Service Code	HCPCS J9181
Hospital Charge Code	0143951001
Hospital Revenue Code	258
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12

ETOPOSIDE 100 MG/5ML IV SOLN

Facility

$2.27

Service Code	HCPCS J9181
Hospital Charge Code	1672911431
Hospital Revenue Code	258
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$1.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.80
Rate for Payer: Aetna Government	$0.80
Rate for Payer: Brighton Health Commercial	$1.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.55
Rate for Payer: EmblemHealth Commercial	$1.14
Rate for Payer: Group Health Inc Commercial	$1.14
Rate for Payer: Group Health Inc Medicare	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.48

ETOPOSIDE 100 MG/5ML IV SOLN

Facility

$2.27

Service Code	HCPCS J9181
Hospital Charge Code	1672911431
Hospital Revenue Code	258
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.14

ETOPOSIDE 100 MG/5ML IV SOLN

Facility

$2.25

Service Code	HCPCS J9181
Hospital Charge Code	0143951001
Hospital Revenue Code	258
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$1.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.80
Rate for Payer: Aetna Government	$0.80
Rate for Payer: Brighton Health Commercial	$1.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.53
Rate for Payer: EmblemHealth Commercial	$1.12
Rate for Payer: Group Health Inc Commercial	$1.12
Rate for Payer: Group Health Inc Medicare	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.46

ETRAVIRINE 100 MG PO TABS

Facility

$14.98

Service Code	NDC 5967657001
Hospital Charge Code	5967657001
Hospital Revenue Code	250
Min. Negotiated Rate	$7.49
Max. Negotiated Rate	$7.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.49

ETRAVIRINE 100 MG PO TABS

Facility

$14.98

Service Code	NDC 5967657001
Hospital Charge Code	5967657001
Hospital Revenue Code	250
Min. Negotiated Rate	$5.24
Max. Negotiated Rate	$11.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.49
Rate for Payer: Aetna Government	$7.49
Rate for Payer: Brighton Health Commercial	$11.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.19
Rate for Payer: EmblemHealth Commercial	$7.49
Rate for Payer: Group Health Inc Commercial	$7.49
Rate for Payer: Group Health Inc Medicare	$5.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.49
Rate for Payer: Hamaspik Choice Inc Medicare	$7.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.74

ETRAVIRINE 200 MG PO TABS

Facility

$26.82

Service Code	NDC 6021917226
Hospital Charge Code	6021917226
Hospital Revenue Code	250
Min. Negotiated Rate	$9.39
Max. Negotiated Rate	$21.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.41
Rate for Payer: Aetna Government	$13.41
Rate for Payer: Brighton Health Commercial	$20.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.24
Rate for Payer: EmblemHealth Commercial	$13.41
Rate for Payer: Group Health Inc Commercial	$13.41
Rate for Payer: Group Health Inc Medicare	$9.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.41
Rate for Payer: Hamaspik Choice Inc Medicare	$13.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.43

ETRAVIRINE 200 MG PO TABS

Facility

$26.82

Service Code	NDC 6021917226
Hospital Charge Code	6021917226
Hospital Revenue Code	250
Min. Negotiated Rate	$13.41
Max. Negotiated Rate	$13.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.41

EVEROLIMUS 0.5 MG PO TABS

Facility

$20.07

Service Code	HCPCS J7527
Hospital Charge Code	6787771933
Hospital Revenue Code	250
Min. Negotiated Rate	$10.04
Max. Negotiated Rate	$10.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.04

EVEROLIMUS 0.5 MG PO TABS

Facility

$20.07

Service Code	HCPCS J7527
Hospital Charge Code	6787771933
Hospital Revenue Code	250
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$16.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.92
Rate for Payer: Aetna Government	$5.92
Rate for Payer: Brighton Health Commercial	$15.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.65
Rate for Payer: EmblemHealth Commercial	$10.04
Rate for Payer: Group Health Inc Commercial	$10.04
Rate for Payer: Group Health Inc Medicare	$7.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.04
Rate for Payer: Hamaspik Choice Inc Medicare	$10.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.05

EXEMESTANE 25 MG PO TABS

Facility

$20.23

Service Code	NDC 6838238306
Hospital Charge Code	6838238306
Hospital Revenue Code	250
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$16.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.12
Rate for Payer: Aetna Government	$10.12
Rate for Payer: Brighton Health Commercial	$15.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.76
Rate for Payer: EmblemHealth Commercial	$10.12
Rate for Payer: Group Health Inc Commercial	$10.12
Rate for Payer: Group Health Inc Medicare	$7.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.12
Rate for Payer: Hamaspik Choice Inc Medicare	$10.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.15

EXEMESTANE 25 MG PO TABS

Facility

$20.23

Service Code	NDC 6838238306
Hospital Charge Code	6838238306
Hospital Revenue Code	250
Min. Negotiated Rate	$10.12
Max. Negotiated Rate	$10.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.12

EXERCISE TOLERANCE TESTS

Facility

$289.65

Service Code	EAPG 00080
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$289.65
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$210.60
Rate for Payer: Healthfirst Commercial	$289.65

EXPANDED HOURS ACCESS

Facility

$24.19

Service Code	EAPG 00448
Min. Negotiated Rate	$18.51
Max. Negotiated Rate	$24.19
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18.51
Rate for Payer: Healthfirst Commercial	$24.19

EXTENDED EEG STUDIES

Facility

$560.75

Service Code	EAPG 00210
Min. Negotiated Rate	$407.32
Max. Negotiated Rate	$560.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$407.32
Rate for Payer: Healthfirst Commercial	$560.75

Know your out-of-pocket cost for care.

All Charges