St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CARVEDILOL 6.25 MG TAB

Facility

$0.20

Hospital Charge Code	41651708
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Brighton Health Commercial	$0.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

CASE MANAGEMENT, PER MONTH

Facility

$112.50

Service Code	HCPCS T2022
Hospital Charge Code	30300185
Hospital Revenue Code	969
Min. Negotiated Rate	$39.38
Max. Negotiated Rate	$180.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.00
Rate for Payer: Aetna Government	$180.00
Rate for Payer: Brighton Health Commercial	$84.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.50
Rate for Payer: Group Health Inc Commercial	$56.25
Rate for Payer: Group Health Inc Medicare	$39.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.25
Rate for Payer: Hamaspik Choice Inc Medicare	$56.25

CASIRIVIMAB

Facility

$0.01

Service Code	HCPCS Q0244
Hospital Charge Code	41650235
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

CASIRIVIMAB

Facility

$0.01

Service Code	HCPCS Q0244
Hospital Charge Code	41640235
Hospital Revenue Code	636
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: 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: United Healthcare Commercial	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CASIRIVIMAB

Facility

$0.01

Service Code	HCPCS Q0244
Hospital Charge Code	41640235
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

CASIRIVIMAB

Facility

$0.01

Service Code	HCPCS Q0244
Hospital Charge Code	41650235
Hospital Revenue Code	636
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: 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: United Healthcare Commercial	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CASIRIVIMAB\IMDEVIMAB

Facility

$0.01

Service Code	HCPCS Q0244
Hospital Charge Code	41640268
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

CASIRIVIMAB\IMDEVIMAB

Facility

$0.01

Service Code	HCPCS Q0244
Hospital Charge Code	41650268
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

CASIRIVIMAB\IMDEVIMAB

Facility

$0.01

Service Code	HCPCS Q0244
Hospital Charge Code	41640268
Hospital Revenue Code	636
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: 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: United Healthcare Commercial	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CASIRIVIMAB\IMDEVIMAB

Facility

$0.01

Service Code	HCPCS Q0244
Hospital Charge Code	41650268
Hospital Revenue Code	636
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: 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: United Healthcare Commercial	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CASIRIVIMAB INFUSION

Facility

$450.00

Service Code	HCPCS M0243
Hospital Charge Code	30300258
Hospital Revenue Code	260
Min. Negotiated Rate	$76.00
Max. Negotiated Rate	$557.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$546.78
Rate for Payer: Aetna Government	$546.78
Rate for Payer: Affinity Essential Plan 1&2	$382.75
Rate for Payer: Affinity Essential Plan 3&4	$382.75
Rate for Payer: Affinity Medicaid/CHP/HARP	$382.75
Rate for Payer: Brighton Health Commercial	$337.50
Rate for Payer: Cash Price	$546.78
Rate for Payer: Cash Price	$546.78
Rate for Payer: Cash Price	$546.78
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$546.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$360.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$306.00
Rate for Payer: Elderplan Medicare Advantage	$546.78
Rate for Payer: EmblemHealth Commercial	$546.78
Rate for Payer: Fidelis Essential Plan Aliesa	$464.76
Rate for Payer: Fidelis Essential Plan QHP	$486.63
Rate for Payer: Fidelis Medicare Advantage	$546.78
Rate for Payer: Fidelis Qualified Health Plan	$486.63
Rate for Payer: Group Health Inc Commercial	$546.78
Rate for Payer: Group Health Inc Medicare	$546.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.00
Rate for Payer: Hamaspik Choice Inc Medicare	$546.78
Rate for Payer: Healthfirst Medicare Advantage	$464.76
Rate for Payer: Healthfirst QHP	$546.78
Rate for Payer: Humana Medicare	$557.72
Rate for Payer: Senior Whole Health Medicare Advantage	$546.78
Rate for Payer: United Healthcare Commercial	$76.00
Rate for Payer: United Healthcare Medicare Advantage	$546.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$546.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$437.42
Rate for Payer: Wellcare Medicare	$519.44

CASIRIVIMAB INFUSION

Facility

$450.00

Service Code	HCPCS M0243
Hospital Charge Code	30300258
Hospital Revenue Code	260
Rate for Payer: Cash Price	$546.78

CASIRIVIMAB REGN 10933

Facility

$0.01

Service Code	HCPCS Q0243
Hospital Charge Code	41650200
Hospital Revenue Code	636
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: 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: United Healthcare Commercial	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CASIRIVIMAB REGN 10933

Facility

$0.01

Service Code	HCPCS Q0243
Hospital Charge Code	41640200
Hospital Revenue Code	636
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: 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: United Healthcare Commercial	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CASIRIVIMAB REGN 10933

Facility

$0.01

Service Code	HCPCS Q0243
Hospital Charge Code	41640200
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

CASIRIVIMAB REGN 10933

Facility

$0.01

Service Code	HCPCS Q0243
Hospital Charge Code	41650200
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

CASPOFUNGIN 50 MG INJ - NF

Facility

$67.17

Service Code	HCPCS J0637
Hospital Charge Code	41652573
Hospital Revenue Code	636
Min. Negotiated Rate	$33.58
Max. Negotiated Rate	$33.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.58
Rate for Payer: Hamaspik Choice Inc Medicare	$33.58

CASPOFUNGIN 50 MG INJ - NF

Facility

$67.17

Service Code	HCPCS J0637
Hospital Charge Code	41642573
Hospital Revenue Code	636
Min. Negotiated Rate	$33.58
Max. Negotiated Rate	$33.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.58
Rate for Payer: Hamaspik Choice Inc Medicare	$33.58

CASPOFUNGIN 50 MG INJ - NF

Facility

$67.17

Service Code	HCPCS J0637
Hospital Charge Code	41642573
Hospital Revenue Code	636
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$43.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.25
Rate for Payer: Aetna Government	$6.25
Rate for Payer: Brighton Health Commercial	$40.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.62
Rate for Payer: Group Health Inc Commercial	$33.58
Rate for Payer: Group Health Inc Medicare	$23.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.58
Rate for Payer: Hamaspik Choice Inc Medicare	$33.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.03
Rate for Payer: SOMOS Essential	$7.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.66

CASPOFUNGIN 50 MG INJ - NF

Facility

$67.17

Service Code	HCPCS J0637
Hospital Charge Code	41652573
Hospital Revenue Code	636
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$43.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.25
Rate for Payer: Aetna Government	$6.25
Rate for Payer: Brighton Health Commercial	$40.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.62
Rate for Payer: Group Health Inc Commercial	$33.58
Rate for Payer: Group Health Inc Medicare	$23.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.58
Rate for Payer: Hamaspik Choice Inc Medicare	$33.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.03
Rate for Payer: SOMOS Essential	$7.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.66

CASPOFUNGIN 70 MG INJ - NF

Facility

$49.55

Service Code	HCPCS J0637
Hospital Charge Code	41652574
Hospital Revenue Code	636
Min. Negotiated Rate	$24.78
Max. Negotiated Rate	$24.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.78
Rate for Payer: Hamaspik Choice Inc Medicare	$24.78

CASPOFUNGIN 70 MG INJ - NF

Facility

$49.55

Service Code	HCPCS J0637
Hospital Charge Code	41642574
Hospital Revenue Code	636
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$32.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.25
Rate for Payer: Aetna Government	$6.25
Rate for Payer: Brighton Health Commercial	$29.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.49
Rate for Payer: Group Health Inc Commercial	$24.78
Rate for Payer: Group Health Inc Medicare	$17.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.78
Rate for Payer: Hamaspik Choice Inc Medicare	$24.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.03
Rate for Payer: SOMOS Essential	$7.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.21

CASPOFUNGIN 70 MG INJ - NF

Facility

$49.55

Service Code	HCPCS J0637
Hospital Charge Code	41652574
Hospital Revenue Code	636
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$32.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.25
Rate for Payer: Aetna Government	$6.25
Rate for Payer: Brighton Health Commercial	$29.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.49
Rate for Payer: Group Health Inc Commercial	$24.78
Rate for Payer: Group Health Inc Medicare	$17.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.78
Rate for Payer: Hamaspik Choice Inc Medicare	$24.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.03
Rate for Payer: SOMOS Essential	$7.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.21

CASPOFUNGIN 70 MG INJ - NF

Facility

$49.55

Service Code	HCPCS J0637
Hospital Charge Code	41642574
Hospital Revenue Code	636
Min. Negotiated Rate	$24.78
Max. Negotiated Rate	$24.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.78
Rate for Payer: Hamaspik Choice Inc Medicare	$24.78

CASTING SAW

Facility

$2,462.63

Hospital Charge Code	64903690
Hospital Revenue Code	270
Min. Negotiated Rate	$861.92
Max. Negotiated Rate	$1,970.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,354.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,231.32
Rate for Payer: Aetna Government	$1,231.32
Rate for Payer: Brighton Health Commercial	$1,846.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,970.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,674.59
Rate for Payer: Group Health Inc Commercial	$1,231.32
Rate for Payer: Group Health Inc Medicare	$861.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,231.32
Rate for Payer: Hamaspik Choice Inc Medicare	$1,231.32

Know your out-of-pocket cost for care.

All Charges