St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

GEMCITABINE HCL 200 MG/5.26ML IV SOLN

Facility

$2.13

Service Code	HCPCS J9201
Hospital Charge Code	0409018301
Hospital Revenue Code	258
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06

GEMCITABINE HCL 200 MG/5.26ML IV SOLN

Facility

$2.13

Service Code	HCPCS J9201
Hospital Charge Code	0409018301
Hospital Revenue Code	258
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$828.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.82
Rate for Payer: Aetna Government	$3.82
Rate for Payer: Affinity Essential Plan 1&2	$18.63
Rate for Payer: Affinity Essential Plan 3&4	$18.63
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.28
Rate for Payer: Amida Care Medicaid	$8.28
Rate for Payer: Brighton Health Commercial	$1.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.45
Rate for Payer: EmblemHealth Commercial	$1.06
Rate for Payer: EmblemHealth Essential Plan 1&2	$18.63
Rate for Payer: EmblemHealth Essential Plan 3&4	$8.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$8.28
Rate for Payer: Fidelis Essential Plan Aliesa	$18.63
Rate for Payer: Fidelis Essential Plan QHP	$18.63
Rate for Payer: Fidelis Qualified Health Plan	$8.69
Rate for Payer: Group Health Inc Commercial	$1.06
Rate for Payer: Group Health Inc Medicare	$0.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.28
Rate for Payer: Hamaspik Choice Inc Medicare	$1.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$828.00
Rate for Payer: Healthfirst Essential Plan	$18.63
Rate for Payer: Healthfirst QHP	$13.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.28
Rate for Payer: SOMOS Essential	$18.63
Rate for Payer: United Healthcare Essential Plan 1&2	$18.63
Rate for Payer: United Healthcare Essential Plan 3&4	$9.11
Rate for Payer: United Healthcare Medicaid	$8.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.38
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.28

GEMCITABINE HCL 2 GM/52.6ML IV SOLN

Facility

$2.07

Service Code	HCPCS J9201
Hospital Charge Code	0409018201
Hospital Revenue Code	258
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$828.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.82
Rate for Payer: Aetna Government	$3.82
Rate for Payer: Affinity Essential Plan 1&2	$18.63
Rate for Payer: Affinity Essential Plan 3&4	$18.63
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.28
Rate for Payer: Amida Care Medicaid	$8.28
Rate for Payer: Brighton Health Commercial	$1.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.41
Rate for Payer: EmblemHealth Commercial	$1.03
Rate for Payer: EmblemHealth Essential Plan 1&2	$18.63
Rate for Payer: EmblemHealth Essential Plan 3&4	$8.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$8.28
Rate for Payer: Fidelis Essential Plan Aliesa	$18.63
Rate for Payer: Fidelis Essential Plan QHP	$18.63
Rate for Payer: Fidelis Qualified Health Plan	$8.69
Rate for Payer: Group Health Inc Commercial	$1.03
Rate for Payer: Group Health Inc Medicare	$0.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.28
Rate for Payer: Hamaspik Choice Inc Medicare	$1.03
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$828.00
Rate for Payer: Healthfirst Essential Plan	$18.63
Rate for Payer: Healthfirst QHP	$13.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.28
Rate for Payer: SOMOS Essential	$18.63
Rate for Payer: United Healthcare Essential Plan 1&2	$18.63
Rate for Payer: United Healthcare Essential Plan 3&4	$9.11
Rate for Payer: United Healthcare Medicaid	$8.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.28

GEMCITABINE HCL 2 GM/52.6ML IV SOLN

Facility

$1.83

Service Code	HCPCS J9201
Hospital Charge Code	6745761810
Hospital Revenue Code	258
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$828.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.82
Rate for Payer: Aetna Government	$3.82
Rate for Payer: Affinity Essential Plan 1&2	$18.63
Rate for Payer: Affinity Essential Plan 3&4	$18.63
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.28
Rate for Payer: Amida Care Medicaid	$8.28
Rate for Payer: Brighton Health Commercial	$1.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.24
Rate for Payer: EmblemHealth Commercial	$0.92
Rate for Payer: EmblemHealth Essential Plan 1&2	$18.63
Rate for Payer: EmblemHealth Essential Plan 3&4	$8.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$8.28
Rate for Payer: Fidelis Essential Plan Aliesa	$18.63
Rate for Payer: Fidelis Essential Plan QHP	$18.63
Rate for Payer: Fidelis Qualified Health Plan	$8.69
Rate for Payer: Group Health Inc Commercial	$0.92
Rate for Payer: Group Health Inc Medicare	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.28
Rate for Payer: Hamaspik Choice Inc Medicare	$0.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$828.00
Rate for Payer: Healthfirst Essential Plan	$18.63
Rate for Payer: Healthfirst QHP	$13.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.28
Rate for Payer: SOMOS Essential	$18.63
Rate for Payer: United Healthcare Essential Plan 1&2	$18.63
Rate for Payer: United Healthcare Essential Plan 3&4	$9.11
Rate for Payer: United Healthcare Medicaid	$8.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.28

GEMCITABINE HCL 2 GM/52.6ML IV SOLN

Facility

$2.07

Service Code	HCPCS J9201
Hospital Charge Code	0409018201
Hospital Revenue Code	258
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.03

GEMCITABINE HCL 2 GM/52.6ML IV SOLN

Facility

$1.83

Service Code	HCPCS J9201
Hospital Charge Code	6745761810
Hospital Revenue Code	258
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.92

GEMFIBROZIL 600 MG PO TABS

Facility

$2.32

Service Code	NDC 6068722411
Hospital Charge Code	6068722411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.16
Rate for Payer: Aetna Government	$1.16
Rate for Payer: Brighton Health Commercial	$1.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.57
Rate for Payer: EmblemHealth Commercial	$1.16
Rate for Payer: Group Health Inc Commercial	$1.16
Rate for Payer: Group Health Inc Medicare	$0.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.16
Rate for Payer: Hamaspik Choice Inc Medicare	$1.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.50

GEMFIBROZIL 600 MG PO TABS

Facility

$2.43

Service Code	NDC 6909782103
Hospital Charge Code	6909782103
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.22

GEMFIBROZIL 600 MG PO TABS

Facility

$2.43

Service Code	NDC 6909782103
Hospital Charge Code	6909782103
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$1.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.22
Rate for Payer: Aetna Government	$1.22
Rate for Payer: Brighton Health Commercial	$1.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.65
Rate for Payer: EmblemHealth Commercial	$1.22
Rate for Payer: Group Health Inc Commercial	$1.22
Rate for Payer: Group Health Inc Medicare	$0.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.22
Rate for Payer: Hamaspik Choice Inc Medicare	$1.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.58

GEMFIBROZIL 600 MG PO TABS

Facility

$2.32

Service Code	NDC 6068722411
Hospital Charge Code	6068722411
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.16

GENETIC COUNSELING

Facility

$222.15

Service Code	EAPG 00882
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$222.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$162.00
Rate for Payer: Healthfirst Commercial	$222.15

GENTAMICIN IN SALINE 0.8-0.9 MG/ML-% IV SOLN

Facility

$0.05

Service Code	HCPCS J1580
Hospital Charge Code	0338050348
Hospital Revenue Code	258
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

GENTAMICIN IN SALINE 0.8-0.9 MG/ML-% IV SOLN

Facility

$0.05

Service Code	HCPCS J1580
Hospital Charge Code	0338050348
Hospital Revenue Code	258
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$2.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
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: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

GENTAMICIN IN SALINE 1-0.9 MG/ML-% IV SOLN

Facility

$0.05

Service Code	HCPCS J1580
Hospital Charge Code	0338050548
Hospital Revenue Code	258
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$2.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
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: EmblemHealth Commercial	$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: Healthfirst CHP/FHP/Medicaid	$2.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

GENTAMICIN IN SALINE 1-0.9 MG/ML-% IV SOLN

Facility

$0.05

Service Code	HCPCS J1580
Hospital Charge Code	0338050548
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03

GENTAMICIN IN SALINE 1.2-0.9 MG/ML-% IV SOLN

Facility

$0.09

Service Code	HCPCS J1580
Hospital Charge Code	0338050741
Hospital Revenue Code	258
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05

GENTAMICIN IN SALINE 1.2-0.9 MG/ML-% IV SOLN

Facility

$0.09

Service Code	HCPCS J1580
Hospital Charge Code	0338050741
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$2.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: EmblemHealth Commercial	$0.05
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.06

GENTAMICIN IN SALINE 1.2-0.9 MG/ML-% IV SOLN

Facility

$0.05

Service Code	HCPCS J1580
Hospital Charge Code	0338050748
Hospital Revenue Code	258
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$2.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
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: EmblemHealth Commercial	$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: Healthfirst CHP/FHP/Medicaid	$2.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

GENTAMICIN IN SALINE 1.2-0.9 MG/ML-% IV SOLN

Facility

$0.05

Service Code	HCPCS J1580
Hospital Charge Code	0338050748
Hospital Revenue Code	258
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03

GENTAMICIN SULFATE 0.3 % OP SOLN

Facility

$4.34

Service Code	NDC 6131463305
Hospital Charge Code	6131463305
Hospital Revenue Code	250
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$2.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.17

GENTAMICIN SULFATE 0.3 % OP SOLN

Facility

$4.34

Service Code	NDC 6131463305
Hospital Charge Code	6131463305
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$3.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Brighton Health Commercial	$3.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.95
Rate for Payer: EmblemHealth Commercial	$2.17
Rate for Payer: Group Health Inc Commercial	$2.17
Rate for Payer: Group Health Inc Medicare	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.17
Rate for Payer: Hamaspik Choice Inc Medicare	$2.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.82

GENTAMICIN SULFATE 0.3 % OP SOLN

Facility

$3.84

Service Code	NDC 6075818805
Hospital Charge Code	6075818805
Hospital Revenue Code	250
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$3.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.92
Rate for Payer: Aetna Government	$1.92
Rate for Payer: Brighton Health Commercial	$2.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.61
Rate for Payer: EmblemHealth Commercial	$1.92
Rate for Payer: Group Health Inc Commercial	$1.92
Rate for Payer: Group Health Inc Medicare	$1.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.92
Rate for Payer: Hamaspik Choice Inc Medicare	$1.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.49

GENTAMICIN SULFATE 0.3 % OP SOLN

Facility

$3.84

Service Code	NDC 6075818805
Hospital Charge Code	6075818805
Hospital Revenue Code	250
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.92

GENTAMICIN SULFATE 10 MG/ML IJ SOLN

Facility

$3.25

Service Code	HCPCS J1580
Hospital Charge Code	6332317301
Hospital Revenue Code	250
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$1.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.62

GENTAMICIN SULFATE 10 MG/ML IJ SOLN

Facility

$3.25

Service Code	HCPCS J1580
Hospital Charge Code	6332317302
Hospital Revenue Code	250
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$2.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$2.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.21
Rate for Payer: EmblemHealth Commercial	$1.62
Rate for Payer: Group Health Inc Commercial	$1.62
Rate for Payer: Group Health Inc Medicare	$1.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1.62
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.11

Know your out-of-pocket cost for care.

All Charges