St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

FERROUS SULFATE 300 (60 FE) MG/5ML PO SOLN

Facility

$0.74

Service Code	NDC 3932815705
Hospital Charge Code	3932815705
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.37
Rate for Payer: Aetna Government	$0.37
Rate for Payer: Brighton Health Commercial	$0.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.50
Rate for Payer: EmblemHealth Commercial	$0.37
Rate for Payer: Group Health Inc Commercial	$0.37
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37
Rate for Payer: Hamaspik Choice Inc Medicare	$0.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.48

FERROUS SULFATE 300 (60 FE) MG/5ML PO SOLN

Facility

$0.81

Service Code	NDC 0121053005
Hospital Charge Code	0121053005
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.41
Rate for Payer: Aetna Government	$0.41
Rate for Payer: Brighton Health Commercial	$0.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.55
Rate for Payer: EmblemHealth Commercial	$0.41
Rate for Payer: Group Health Inc Commercial	$0.41
Rate for Payer: Group Health Inc Medicare	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.41
Rate for Payer: Hamaspik Choice Inc Medicare	$0.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.53

FERROUS SULFATE 300 (60 FE) MG/5ML PO SOLN

Facility

$0.81

Service Code	NDC 0121053005
Hospital Charge Code	0121053005
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.41

FERROUS SULFATE 300 (60 FE) MG/5ML PO SOLN

Facility

$0.52

Service Code	NDC 0904727770
Hospital Charge Code	0904727770
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.26
Rate for Payer: Aetna Government	$0.26
Rate for Payer: Brighton Health Commercial	$0.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.36
Rate for Payer: EmblemHealth Commercial	$0.26
Rate for Payer: Group Health Inc Commercial	$0.26
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26
Rate for Payer: Hamaspik Choice Inc Medicare	$0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.34

FERROUS SULFATE 300 (60 FE) MG/5ML PO SOLN

Facility

$0.52

Service Code	NDC 0904727741
Hospital Charge Code	0904727741
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.26
Rate for Payer: Aetna Government	$0.26
Rate for Payer: Brighton Health Commercial	$0.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.36
Rate for Payer: EmblemHealth Commercial	$0.26
Rate for Payer: Group Health Inc Commercial	$0.26
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26
Rate for Payer: Hamaspik Choice Inc Medicare	$0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.34

FERROUS SULFATE 324 (65 FE) MG PO TBEC

Facility

$0.11

Service Code	NDC 0574060811
Hospital Charge Code	0574060811
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06

FERROUS SULFATE 324 (65 FE) MG PO TBEC

Facility

$0.11

Service Code	NDC 0574060811
Hospital Charge Code	0574060811
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: EmblemHealth Commercial	$0.06
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

FERROUS SULFATE 325 (65 FE) MG PO TABS

Facility

$0.01

Service Code	NDC 5789670310
Hospital Charge Code	5789670310
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: EmblemHealth Commercial	$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

FERROUS SULFATE 325 (65 FE) MG PO TABS

Facility

$0.03

Service Code	NDC 0536100901
Hospital Charge Code	0536100901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

FERROUS SULFATE 325 (65 FE) MG PO TABS

Facility

$0.04

Service Code	NDC 0904759161
Hospital Charge Code	0904759161
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

FERROUS SULFATE 325 (65 FE) MG PO TABS

Facility

$0.04

Service Code	NDC 0904759161
Hospital Charge Code	0904759161
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

FERROUS SULFATE 325 (65 FE) MG PO TABS

Facility

$0.03

Service Code	NDC 0536100901
Hospital Charge Code	0536100901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

FERROUS SULFATE 325 (65 FE) MG PO TABS

Facility

$0.01

Service Code	NDC 5789670310
Hospital Charge Code	5789670310
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

FERROUS SULFATE 75 (15 FE) MG/ML PO SOLN

Facility

$0.18

Service Code	NDC 5038362750
Hospital Charge Code	5038362750
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Brighton Health Commercial	$0.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.12
Rate for Payer: EmblemHealth Commercial	$0.09
Rate for Payer: Group Health Inc Commercial	$0.09
Rate for Payer: Group Health Inc Medicare	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.12

FERROUS SULFATE 75 (15 FE) MG/ML PO SOLN

Facility

$0.18

Service Code	NDC 5038362750
Hospital Charge Code	5038362750
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09

FERROUS SULFATE 75 (15 FE) MG/ML PO SOLN

Facility

$0.21

Service Code	NDC 0087074002
Hospital Charge Code	0087074002
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.11
Rate for Payer: Aetna Government	$0.11
Rate for Payer: Brighton Health Commercial	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.15
Rate for Payer: EmblemHealth Commercial	$0.11
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11
Rate for Payer: Hamaspik Choice Inc Medicare	$0.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.14

FERROUS SULFATE 75 (15 FE) MG/ML PO SOLN

Facility

$0.21

Service Code	NDC 0087074002
Hospital Charge Code	0087074002
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

FERROUS SULFATE 75 (15 FE) MG/ML PO SOLN

Facility

$0.12

Service Code	NDC 5483801150
Hospital Charge Code	5483801150
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: EmblemHealth Commercial	$0.06
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

FERROUS SULFATE 75 (15 FE) MG/ML PO SOLN

Facility

$0.12

Service Code	NDC 5483801150
Hospital Charge Code	5483801150
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06

Fever

Facility

$46,948.43

Service Code	APR-DRG 7223
Min. Negotiated Rate	$9,387.00
Max. Negotiated Rate	$46,948.43
Rate for Payer: Affinity Essential Plan 1&2	$46,948.43
Rate for Payer: Affinity Essential Plan 3&4	$46,948.43
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,865.97
Rate for Payer: Amida Care Medicaid	$20,865.97
Rate for Payer: EmblemHealth Essential Plan 1&2	$46,948.43
Rate for Payer: EmblemHealth Essential Plan 3&4	$20,865.97
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,865.97
Rate for Payer: Fidelis Qualified Health Plan	$25,039.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,865.97
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,865.97
Rate for Payer: Healthfirst Commercial	$16,097.00
Rate for Payer: Healthfirst Essential Plan	$46,948.43
Rate for Payer: Healthfirst QHP	$9,387.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,865.97
Rate for Payer: SOMOS Essential	$46,948.43
Rate for Payer: United Healthcare Essential Plan 1&2	$46,948.43
Rate for Payer: United Healthcare Essential Plan 3&4	$46,948.43
Rate for Payer: United Healthcare Medicaid	$20,865.97
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,865.97

Fever

Facility

$42,303.58

Service Code	APR-DRG 7222
Min. Negotiated Rate	$6,894.00
Max. Negotiated Rate	$42,303.58
Rate for Payer: Affinity Essential Plan 1&2	$42,303.58
Rate for Payer: Affinity Essential Plan 3&4	$42,303.58
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,801.59
Rate for Payer: Amida Care Medicaid	$18,801.59
Rate for Payer: EmblemHealth Essential Plan 1&2	$42,303.58
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,801.59
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,801.59
Rate for Payer: Fidelis Qualified Health Plan	$22,561.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,801.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,801.59
Rate for Payer: Healthfirst Commercial	$11,665.00
Rate for Payer: Healthfirst Essential Plan	$42,303.58
Rate for Payer: Healthfirst QHP	$6,894.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,801.59
Rate for Payer: SOMOS Essential	$42,303.58
Rate for Payer: United Healthcare Essential Plan 1&2	$42,303.58
Rate for Payer: United Healthcare Essential Plan 3&4	$42,303.58
Rate for Payer: United Healthcare Medicaid	$18,801.59
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,801.59

Fever

Facility

$41,046.07

Service Code	APR-DRG 7221
Min. Negotiated Rate	$5,549.00
Max. Negotiated Rate	$41,046.07
Rate for Payer: Affinity Essential Plan 1&2	$41,046.07
Rate for Payer: Affinity Essential Plan 3&4	$41,046.07
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,242.70
Rate for Payer: Amida Care Medicaid	$18,242.70
Rate for Payer: EmblemHealth Essential Plan 1&2	$41,046.07
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,242.70
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,242.70
Rate for Payer: Fidelis Qualified Health Plan	$21,891.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,242.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,242.70
Rate for Payer: Healthfirst Commercial	$9,937.00
Rate for Payer: Healthfirst Essential Plan	$41,046.07
Rate for Payer: Healthfirst QHP	$5,549.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,242.70
Rate for Payer: SOMOS Essential	$41,046.07
Rate for Payer: United Healthcare Essential Plan 1&2	$41,046.07
Rate for Payer: United Healthcare Essential Plan 3&4	$41,046.07
Rate for Payer: United Healthcare Medicaid	$18,242.70
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,242.70

Fever

Facility

$63,533.41

Service Code	APR-DRG 7224
Min. Negotiated Rate	$17,661.00
Max. Negotiated Rate	$63,533.41
Rate for Payer: Affinity Essential Plan 1&2	$63,533.41
Rate for Payer: Affinity Essential Plan 3&4	$63,533.41
Rate for Payer: Affinity Medicaid/CHP/HARP	$28,237.07
Rate for Payer: Amida Care Medicaid	$28,237.07
Rate for Payer: EmblemHealth Essential Plan 1&2	$63,533.41
Rate for Payer: EmblemHealth Essential Plan 3&4	$28,237.07
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,237.07
Rate for Payer: Fidelis Qualified Health Plan	$33,884.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,237.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,237.07
Rate for Payer: Healthfirst Commercial	$24,361.00
Rate for Payer: Healthfirst Essential Plan	$63,533.41
Rate for Payer: Healthfirst QHP	$17,661.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,237.07
Rate for Payer: SOMOS Essential	$63,533.41
Rate for Payer: United Healthcare Essential Plan 1&2	$63,533.41
Rate for Payer: United Healthcare Essential Plan 3&4	$63,533.41
Rate for Payer: United Healthcare Medicaid	$28,237.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,237.07

FEVER

Facility

$228.09

Service Code	EAPG 00807
Min. Negotiated Rate	$166.63
Max. Negotiated Rate	$228.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$166.63
Rate for Payer: Healthfirst Commercial	$228.09

FIDAXOMICIN 200 MG PO TABS

Facility

$298.85

Service Code	NDC 5201508001
Hospital Charge Code	5201508001
Hospital Revenue Code	250
Min. Negotiated Rate	$149.42
Max. Negotiated Rate	$149.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$149.42

Know your out-of-pocket cost for care.

All Charges