St. Barnabas Hospital

All Charges

Charge

Type

Price

CEFEPIME 0.5 GRAMS INJ

Facility IP

$10.26

Service Code	HCPCS J0692
Hospital Charge Code	41653344
Hospital Revenue Code	636
Min. Negotiated Rate	$5.13
Max. Negotiated Rate	$5.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.13
Rate for Payer: Hamaspik Choice Inc Medicare	$5.13

CEFEPIME 0.5 GRAMS INJ

Facility OP

$10.26

Service Code	HCPCS J0692
Hospital Charge Code	41653344
Hospital Revenue Code	636
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$6.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.10
Rate for Payer: Group Health Inc Commercial	$5.13
Rate for Payer: Group Health Inc Medicare	$3.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.13
Rate for Payer: Hamaspik Choice Inc Medicare	$5.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.42
Rate for Payer: SOMOS Essential	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.67

CEFEPIME 0.5 GRAMS INJ

Facility OP

$10.26

Service Code	HCPCS J0692
Hospital Charge Code	41643344
Hospital Revenue Code	636
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$6.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.10
Rate for Payer: Group Health Inc Commercial	$5.13
Rate for Payer: Group Health Inc Medicare	$3.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.13
Rate for Payer: Hamaspik Choice Inc Medicare	$5.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.42
Rate for Payer: SOMOS Essential	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.67

CEFEPIME 1 GRAM INJ

Facility IP

$3.71

Service Code	HCPCS J0692
Hospital Charge Code	41643299
Hospital Revenue Code	636
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$1.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.86
Rate for Payer: Hamaspik Choice Inc Medicare	$1.86

CEFEPIME 1 GRAM INJ

Facility IP

$3.71

Service Code	HCPCS J0692
Hospital Charge Code	41653299
Hospital Revenue Code	636
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$1.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.86
Rate for Payer: Hamaspik Choice Inc Medicare	$1.86

CEFEPIME 1 GRAM INJ

Facility OP

$3.71

Service Code	HCPCS J0692
Hospital Charge Code	41643299
Hospital Revenue Code	636
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$2.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.13
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.10
Rate for Payer: Group Health Inc Commercial	$1.86
Rate for Payer: Group Health Inc Medicare	$1.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.86
Rate for Payer: Hamaspik Choice Inc Medicare	$1.86
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.42
Rate for Payer: SOMOS Essential	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.41

CEFEPIME 1 GRAM INJ

Facility OP

$3.71

Service Code	HCPCS J0692
Hospital Charge Code	41653299
Hospital Revenue Code	636
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$2.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.13
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.10
Rate for Payer: Group Health Inc Commercial	$1.86
Rate for Payer: Group Health Inc Medicare	$1.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.86
Rate for Payer: Hamaspik Choice Inc Medicare	$1.86
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.42
Rate for Payer: SOMOS Essential	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.41

CEFEPIME 2 GRAMS INJ

Facility OP

$3.00

Service Code	HCPCS J0692
Hospital Charge Code	41653345
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.10
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.42
Rate for Payer: SOMOS Essential	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

CEFEPIME 2 GRAMS INJ

Facility OP

$3.00

Service Code	HCPCS J0692
Hospital Charge Code	41643345
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.10
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.42
Rate for Payer: SOMOS Essential	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

CEFEPIME 2 GRAMS INJ

Facility IP

$3.00

Service Code	HCPCS J0692
Hospital Charge Code	41643345
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

CEFEPIME 2 GRAMS INJ

Facility IP

$3.00

Service Code	HCPCS J0692
Hospital Charge Code	41653345
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

CEFEPIME 40MG/ML INJ PED

Facility OP

$7.21

Service Code	HCPCS J0692
Hospital Charge Code	41659543
Hospital Revenue Code	636
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$4.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.10
Rate for Payer: Group Health Inc Commercial	$3.60
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.42
Rate for Payer: SOMOS Essential	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.69

CEFEPIME 40MG/ML INJ PED

Facility IP

$7.21

Service Code	HCPCS J0692
Hospital Charge Code	41659543
Hospital Revenue Code	636
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60

CEFEPIME 500MG IM

Facility OP

$8.00

Service Code	HCPCS J0692
Hospital Charge Code	41645917
Hospital Revenue Code	636
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$5.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.60
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.10
Rate for Payer: Group Health Inc Commercial	$4.00
Rate for Payer: Group Health Inc Medicare	$2.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.42
Rate for Payer: SOMOS Essential	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.20

CEFEPIME 500MG IM

Facility IP

$8.00

Service Code	HCPCS J0692
Hospital Charge Code	41645917
Hospital Revenue Code	636
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$4.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00

CEFIDEROCOL

Facility IP

$4.73

Service Code	HCPCS J0699
Hospital Charge Code	41640343
Hospital Revenue Code	636
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$2.36
Rate for Payer: Cash Price	$2.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36

CEFIDEROCOL

Facility OP

$4.73

Service Code	HCPCS J0699
Hospital Charge Code	41640343
Hospital Revenue Code	636
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$3.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Cash Price	$2.17
Rate for Payer: Cash Price	$2.17
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Elderplan Medicare Advantage	$2.17
Rate for Payer: EmblemHealth Commercial	$2.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2.17
Rate for Payer: Fidelis Essential Plan Aliesa	$2.17
Rate for Payer: Fidelis Essential Plan QHP	$2.28
Rate for Payer: Fidelis Medicare Advantage	$2.17
Rate for Payer: Fidelis Qualified Health Plan	$2.28
Rate for Payer: Group Health Inc Commercial	$2.17
Rate for Payer: Group Health Inc Medicare	$2.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.16
Rate for Payer: Healthfirst Medicare Advantage	$1.85
Rate for Payer: Healthfirst QHP	$2.17
Rate for Payer: Senior Whole Health Medicare Advantage	$2.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.30
Rate for Payer: SOMOS Essential	$2.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1.74
Rate for Payer: Wellcare Medicare	$2.06

CEFIDEROCOL

Facility OP

$4.73

Service Code	HCPCS J0699
Hospital Charge Code	41650343
Hospital Revenue Code	636
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$3.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Cash Price	$2.17
Rate for Payer: Cash Price	$2.17
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Elderplan Medicare Advantage	$2.17
Rate for Payer: EmblemHealth Commercial	$2.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2.17
Rate for Payer: Fidelis Essential Plan Aliesa	$2.17
Rate for Payer: Fidelis Essential Plan QHP	$2.28
Rate for Payer: Fidelis Medicare Advantage	$2.17
Rate for Payer: Fidelis Qualified Health Plan	$2.28
Rate for Payer: Group Health Inc Commercial	$2.17
Rate for Payer: Group Health Inc Medicare	$2.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.16
Rate for Payer: Healthfirst Medicare Advantage	$1.85
Rate for Payer: Healthfirst QHP	$2.17
Rate for Payer: Senior Whole Health Medicare Advantage	$2.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.30
Rate for Payer: SOMOS Essential	$2.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1.74
Rate for Payer: Wellcare Medicare	$2.06

CEFIDEROCOL

Facility IP

$4.73

Service Code	HCPCS J0699
Hospital Charge Code	41650343
Hospital Revenue Code	636
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$2.36
Rate for Payer: Cash Price	$2.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36

CEFIXIME 200MG/5ML SUSP

Facility OP

$7.00

Hospital Charge Code	41645090
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

CEFIXIME 200MG/5ML SUSP

Facility OP

$7.00

Hospital Charge Code	41655090
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

CEFIXIME 400 MG TAB

Facility OP

$31.00

Hospital Charge Code	41644910
Hospital Revenue Code	250
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$24.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.50
Rate for Payer: Aetna Government	$15.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.08
Rate for Payer: Group Health Inc Commercial	$15.50
Rate for Payer: Group Health Inc Medicare	$10.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.50
Rate for Payer: Hamaspik Choice Inc Medicare	$15.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.15

CEFIXIME 400 MG TAB

Facility OP

$31.00

Hospital Charge Code	41654910
Hospital Revenue Code	250
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$24.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.50
Rate for Payer: Aetna Government	$15.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.08
Rate for Payer: Group Health Inc Commercial	$15.50
Rate for Payer: Group Health Inc Medicare	$10.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.50
Rate for Payer: Hamaspik Choice Inc Medicare	$15.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.15

CEFOTAXIME 1000 MG INJ

Facility OP

$3.21

Service Code	HCPCS J0698
Hospital Charge Code	41651782
Hospital Revenue Code	636
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$8.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.11
Rate for Payer: Aetna Government	$8.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.85
Rate for Payer: Group Health Inc Commercial	$1.60
Rate for Payer: Group Health Inc Medicare	$1.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.09

CEFOTAXIME 1000 MG INJ

Facility IP

$3.21

Service Code	HCPCS J0698
Hospital Charge Code	41641782
Hospital Revenue Code	636
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$1.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1.60

Price Transparency.

All Charges