St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CALCIUM CARBONATE 1250 MG TAB

Facility

$0.02

Hospital Charge Code	41652228
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.02
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	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.01
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

CALCIUM CARBONATE ANTACID 1250 MG/5ML PO SUSP [145997]

Facility

$0.62

Service Code	NDC 00121476605
Hospital Charge Code	00121476605
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.31
Rate for Payer: Aetna Government	$0.31
Rate for Payer: Brighton Health Commercial	$0.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.42
Rate for Payer: Group Health Inc Commercial	$0.31
Rate for Payer: Group Health Inc Medicare	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.40

CALCIUM CARBONATE ANTACID 1250 MG/5ML PO SUSP [145997]

Facility

$0.03

Service Code	NDC 00054311763
Hospital Charge Code	00054311763
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.02
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	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.01
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	$0.02

CALCIUM CARBONATE SUS 1250MG/5ML

Facility

$1.00

Hospital Charge Code	41646032
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
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: 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

CALCIUM CARBONATE SUS 1250MG/5ML

Facility

$1.00

Hospital Charge Code	41656032
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
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: 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

CALCIUM CHLORIDE 10% INJ SYRINGE 10 ML

Facility

$4.00

Hospital Charge Code	41643820
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

CALCIUM CHLORIDE 10% INJ SYRINGE 10 ML

Facility

$4.00

Hospital Charge Code	41653820
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

CALCIUM CHLORIDE 10 % IV SOLN [1306]

Facility

$1.87

Service Code	NDC 00409492834
Hospital Charge Code	00409492834
Hospital Revenue Code	278
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$0.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.93
Rate for Payer: Hamaspik Choice Inc Medicare	$0.93

CALCIUM CHLORIDE 10 % IV SOLN [1306]

Facility

$1.87

Service Code	NDC 00409492834
Hospital Charge Code	00409492834
Hospital Revenue Code	278
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$1.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.93
Rate for Payer: Aetna Government	$0.93
Rate for Payer: Brighton Health Commercial	$1.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.07
Rate for Payer: EmblemHealth Commercial	$0.93
Rate for Payer: Fidelis Medicare Advantage	$1.96
Rate for Payer: Group Health Inc Commercial	$0.93
Rate for Payer: Group Health Inc Medicare	$0.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.93
Rate for Payer: Hamaspik Choice Inc Medicare	$0.93
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.21

CALCIUM CHLORIDE 10 % IV SOLN [1306]

Facility

$1.26

Service Code	NDC 76329330401
Hospital Charge Code	76329330401
Hospital Revenue Code	278
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$1.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.63
Rate for Payer: Aetna Government	$0.63
Rate for Payer: Brighton Health Commercial	$0.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.72
Rate for Payer: EmblemHealth Commercial	$0.63
Rate for Payer: Fidelis Medicare Advantage	$1.32
Rate for Payer: Group Health Inc Commercial	$0.63
Rate for Payer: Group Health Inc Medicare	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.63
Rate for Payer: Hamaspik Choice Inc Medicare	$0.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.82

CALCIUM CHLORIDE 10 % IV SOLN [1306]

Facility

$1.26

Service Code	NDC 76329330401
Hospital Charge Code	76329330401
Hospital Revenue Code	278
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$0.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.63
Rate for Payer: Hamaspik Choice Inc Medicare	$0.63

CALCIUM CITRATE 950MG TAB

Facility

$0.05

Hospital Charge Code	41648419
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

CALCIUM CITRATE 950MG TAB

Facility

$0.05

Hospital Charge Code	41658419
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

CALCIUM GLUBIONATE 23 MG/ML SYRUP PEDIAT

Facility

$1.00

Hospital Charge Code	41653544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
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: 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

CALCIUM GLUBIONATE 23 MG/ML SYRUP PEDIAT

Facility

$1.00

Hospital Charge Code	41643544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
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: 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

CALCIUM GLUCONATE 100 MG/ML INJ 10 ML

Facility

$4.08

Service Code	HCPCS J0610
Hospital Charge Code	41650213
Hospital Revenue Code	636
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Brighton Health Commercial	$2.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.35
Rate for Payer: Group Health Inc Commercial	$2.04
Rate for Payer: Group Health Inc Medicare	$1.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.65

CALCIUM GLUCONATE 100 MG/ML INJ 10 ML

Facility

$4.08

Service Code	HCPCS J0610
Hospital Charge Code	41640213
Hospital Revenue Code	636
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Brighton Health Commercial	$2.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.35
Rate for Payer: Group Health Inc Commercial	$2.04
Rate for Payer: Group Health Inc Medicare	$1.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.65

CALCIUM GLUCONATE 100 MG/ML INJ 10 ML

Facility

$4.08

Service Code	HCPCS J0610
Hospital Charge Code	41640213
Hospital Revenue Code	636
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2.04

CALCIUM GLUCONATE 100 MG/ML INJ 10 ML

Facility

$4.08

Service Code	HCPCS J0610
Hospital Charge Code	41650213
Hospital Revenue Code	636
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2.04

CALCIUM GLUCONATE 100 MG/ML INJ 50 ML

Facility

$1.29

Service Code	HCPCS J0610
Hospital Charge Code	41651038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65

CALCIUM GLUCONATE 100 MG/ML INJ 50 ML

Facility

$1.29

Service Code	HCPCS J0610
Hospital Charge Code	41651038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Brighton Health Commercial	$0.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.74
Rate for Payer: Group Health Inc Commercial	$0.65
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.84

CALCIUM GLUCONATE 100 MG/ML INJ 50 ML

Facility

$1.29

Service Code	HCPCS J0610
Hospital Charge Code	41641038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65

CALCIUM GLUCONATE 100 MG/ML INJ 50 ML

Facility

$1.29

Service Code	HCPCS J0610
Hospital Charge Code	41641038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Brighton Health Commercial	$0.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.74
Rate for Payer: Group Health Inc Commercial	$0.65
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.84

CALCIUM GLUCONATE 10 % IV SOLN [1312]

Facility

$1.20

Service Code	HCPCS J0610
Hospital Charge Code	63323036019
Hospital Revenue Code	278
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Brighton Health Commercial	$0.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.69
Rate for Payer: EmblemHealth Commercial	$0.60
Rate for Payer: Fidelis Medicare Advantage	$1.26
Rate for Payer: Group Health Inc Commercial	$0.60
Rate for Payer: Group Health Inc Medicare	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.60
Rate for Payer: Hamaspik Choice Inc Medicare	$0.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.78

CALCIUM GLUCONATE 10 % IV SOLN [1312]

Facility

$1.20

Service Code	HCPCS J0610
Hospital Charge Code	00143918025
Hospital Revenue Code	278
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Brighton Health Commercial	$0.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.69
Rate for Payer: EmblemHealth Commercial	$0.60
Rate for Payer: Fidelis Medicare Advantage	$1.26
Rate for Payer: Group Health Inc Commercial	$0.60
Rate for Payer: Group Health Inc Medicare	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.60
Rate for Payer: Hamaspik Choice Inc Medicare	$0.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.78

Know your out-of-pocket cost for care.

All Charges