St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

FINASTERIDE 5 MG PO TABS

Facility

$3.11

Service Code	NDC 1672909010
Hospital Charge Code	1672909010
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$2.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.56
Rate for Payer: Aetna Government	$1.56
Rate for Payer: Brighton Health Commercial	$2.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.12
Rate for Payer: EmblemHealth Commercial	$1.56
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.02

FINASTERIDE 5 MG PO TABS

Facility

$1.24

Service Code	NDC 0904683061
Hospital Charge Code	0904683061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.62
Rate for Payer: Aetna Government	$0.62
Rate for Payer: Brighton Health Commercial	$0.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.84
Rate for Payer: EmblemHealth Commercial	$0.62
Rate for Payer: Group Health Inc Commercial	$0.62
Rate for Payer: Group Health Inc Medicare	$0.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.62
Rate for Payer: Hamaspik Choice Inc Medicare	$0.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.80

FINASTERIDE 5 MG PO TABS

Facility

$3.13

Service Code	NDC 5026831411
Hospital Charge Code	5026831411
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56

FINASTERIDE 5 MG PO TABS

Facility

$1.24

Service Code	NDC 0904683061
Hospital Charge Code	0904683061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.62

FINASTERIDE 5 MG PO TABS

Facility

$3.11

Service Code	NDC 1672909010
Hospital Charge Code	1672909010
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56

FIRST-METRONIDAZOLE 50 MG/ML PO SUSR

Facility

$0.60

Service Code	NDC 6562820205
Hospital Charge Code	6562820205
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.41
Rate for Payer: EmblemHealth Commercial	$0.30
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.39

FIRST-METRONIDAZOLE 50 MG/ML PO SUSR

Facility

$0.60

Service Code	NDC 6562820205
Hospital Charge Code	6562820205
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30

FIRST-MOUTHWASH BLM MT SUSP

Facility

$0.63

Service Code	NDC 6562805001
Hospital Charge Code	6562805001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$0.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.32

FIRST-MOUTHWASH BLM MT SUSP

Facility

$0.91

Service Code	NDC 6562805004
Hospital Charge Code	6562805004
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45

FIRST-MOUTHWASH BLM MT SUSP

Facility

$0.63

Service Code	NDC 6562805001
Hospital Charge Code	6562805001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.32
Rate for Payer: Aetna Government	$0.32
Rate for Payer: Brighton Health Commercial	$0.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.43
Rate for Payer: EmblemHealth Commercial	$0.32
Rate for Payer: Group Health Inc Commercial	$0.32
Rate for Payer: Group Health Inc Medicare	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.32
Rate for Payer: Hamaspik Choice Inc Medicare	$0.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.41

FIRST-MOUTHWASH BLM MT SUSP

Facility

$0.91

Service Code	NDC 6562805004
Hospital Charge Code	6562805004
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$0.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.45
Rate for Payer: Aetna Government	$0.45
Rate for Payer: Brighton Health Commercial	$0.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.62
Rate for Payer: EmblemHealth Commercial	$0.45
Rate for Payer: Group Health Inc Commercial	$0.45
Rate for Payer: Group Health Inc Medicare	$0.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.45
Rate for Payer: Hamaspik Choice Inc Medicare	$0.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.59

FIXATION DEVICE INSERTION OR REPLACEMENT PROCEDURES

Facility

$2,163.87

Service Code	EAPG 00054
Min. Negotiated Rate	$2,163.87
Max. Negotiated Rate	$2,163.87
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,163.87

FLEET PEDIATRIC 3.5-9.5 GM/59ML RE ENEM

Facility

$0.03

Service Code	NDC 0132020220
Hospital Charge Code	0132020220
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

FLEET PEDIATRIC 3.5-9.5 GM/59ML RE ENEM

Facility

$0.03

Service Code	NDC 0132020220
Hospital Charge Code	0132020220
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

FLEET SALINE ENEMA 7-19 GM/197ML RE ENEM

Facility

$0.01

Service Code	NDC 0132020142
Hospital Charge Code	0132020142
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

FLEET SALINE ENEMA 7-19 GM/197ML RE ENEM

Facility

$0.01

Service Code	NDC 0132020142
Hospital Charge Code	0132020142
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

FLEET SALINE ENEMA 7-19 GM/197ML RE ENEM

Facility

$0.01

Service Code	NDC 0132020145
Hospital Charge Code	0132020145
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

FLEET SALINE ENEMA 7-19 GM/197ML RE ENEM

Facility

$0.01

Service Code	NDC 0132020140
Hospital Charge Code	0132020140
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

FLEET SALINE ENEMA 7-19 GM/197ML RE ENEM

Facility

$0.01

Service Code	NDC 0132020140
Hospital Charge Code	0132020140
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

FLEET SALINE ENEMA 7-19 GM/197ML RE ENEM

Facility

$0.01

Service Code	NDC 0132020145
Hospital Charge Code	0132020145
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

FLUCONAZOLE 100 MG PO TABS

Facility

$9.53

Service Code	NDC 5026833715
Hospital Charge Code	5026833715
Hospital Revenue Code	250
Min. Negotiated Rate	$4.77
Max. Negotiated Rate	$4.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.77

FLUCONAZOLE 100 MG PO TABS

Facility

$8.75

Service Code	NDC 7071011383
Hospital Charge Code	7071011383
Hospital Revenue Code	250
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$7.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.38
Rate for Payer: Aetna Government	$4.38
Rate for Payer: Brighton Health Commercial	$6.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.95
Rate for Payer: EmblemHealth Commercial	$4.38
Rate for Payer: Group Health Inc Commercial	$4.38
Rate for Payer: Group Health Inc Medicare	$3.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.38
Rate for Payer: Hamaspik Choice Inc Medicare	$4.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.69

FLUCONAZOLE 100 MG PO TABS

Facility

$1.59

Service Code	NDC 0904650006
Hospital Charge Code	0904650006
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.80
Rate for Payer: Aetna Government	$0.80
Rate for Payer: Brighton Health Commercial	$1.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.08
Rate for Payer: EmblemHealth Commercial	$0.80
Rate for Payer: Group Health Inc Commercial	$0.80
Rate for Payer: Group Health Inc Medicare	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80
Rate for Payer: Hamaspik Choice Inc Medicare	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.03

FLUCONAZOLE 100 MG PO TABS

Facility

$9.53

Service Code	NDC 5026833715
Hospital Charge Code	5026833715
Hospital Revenue Code	250
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$7.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.77
Rate for Payer: Aetna Government	$4.77
Rate for Payer: Brighton Health Commercial	$7.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.48
Rate for Payer: EmblemHealth Commercial	$4.77
Rate for Payer: Group Health Inc Commercial	$4.77
Rate for Payer: Group Health Inc Medicare	$3.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.77
Rate for Payer: Hamaspik Choice Inc Medicare	$4.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.20

FLUCONAZOLE 100 MG PO TABS

Facility

$9.71

Service Code	NDC 0904650061
Hospital Charge Code	0904650061
Hospital Revenue Code	250
Min. Negotiated Rate	$4.85
Max. Negotiated Rate	$4.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.85

Know your out-of-pocket cost for care.

All Charges