St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ANASTROZOLE 1 MG PO TABS

Facility

$2.07

Service Code	NDC 6068711221
Hospital Charge Code	6068711221
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.04

ANCILLARY DRUG ADMINISTRATION

Facility

$48.60

Service Code	EAPG 00109
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$48.60

ANEMIA, BLOOD AND BLOOD-FORMING ORGAN DISORDERS

Facility

$209.55

Service Code	EAPG 00785
Min. Negotiated Rate	$152.74
Max. Negotiated Rate	$209.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$152.74
Rate for Payer: Healthfirst Commercial	$209.55

ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS

Facility

$220.42

Service Code	EAPG 00598
Min. Negotiated Rate	$159.69
Max. Negotiated Rate	$220.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$159.69
Rate for Payer: Healthfirst Commercial	$220.42

Angina pectoris & coronary atherosclerosis

Facility

$39,197.63

Service Code	APR-DRG 1981
Min. Negotiated Rate	$5,053.00
Max. Negotiated Rate	$39,197.63
Rate for Payer: Affinity Essential Plan 1&2	$39,197.63
Rate for Payer: Affinity Essential Plan 3&4	$39,197.63
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,421.17
Rate for Payer: Amida Care Medicaid	$17,421.17
Rate for Payer: EmblemHealth Essential Plan 1&2	$39,197.63
Rate for Payer: EmblemHealth Essential Plan 3&4	$17,421.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,421.17
Rate for Payer: Fidelis Qualified Health Plan	$20,905.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,421.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,421.17
Rate for Payer: Healthfirst Commercial	$8,836.00
Rate for Payer: Healthfirst Essential Plan	$39,197.63
Rate for Payer: Healthfirst QHP	$5,053.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,421.17
Rate for Payer: SOMOS Essential	$39,197.63
Rate for Payer: United Healthcare Essential Plan 1&2	$39,197.63
Rate for Payer: United Healthcare Essential Plan 3&4	$39,197.63
Rate for Payer: United Healthcare Medicaid	$17,421.17
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,421.17

Angina pectoris & coronary atherosclerosis

Facility

$46,397.93

Service Code	APR-DRG 1983
Min. Negotiated Rate	$7,870.00
Max. Negotiated Rate	$46,397.93
Rate for Payer: Affinity Essential Plan 1&2	$46,397.93
Rate for Payer: Affinity Essential Plan 3&4	$46,397.93
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,621.30
Rate for Payer: Amida Care Medicaid	$20,621.30
Rate for Payer: EmblemHealth Essential Plan 1&2	$46,397.93
Rate for Payer: EmblemHealth Essential Plan 3&4	$20,621.30
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,621.30
Rate for Payer: Fidelis Qualified Health Plan	$24,745.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,621.30
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,621.30
Rate for Payer: Healthfirst Commercial	$15,856.00
Rate for Payer: Healthfirst Essential Plan	$46,397.93
Rate for Payer: Healthfirst QHP	$7,870.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,621.30
Rate for Payer: SOMOS Essential	$46,397.93
Rate for Payer: United Healthcare Essential Plan 1&2	$46,397.93
Rate for Payer: United Healthcare Essential Plan 3&4	$46,397.93
Rate for Payer: United Healthcare Medicaid	$20,621.30
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,621.30

Angina pectoris & coronary atherosclerosis

Facility

$74,590.63

Service Code	APR-DRG 1984
Min. Negotiated Rate	$13,272.00
Max. Negotiated Rate	$74,590.63
Rate for Payer: Affinity Essential Plan 1&2	$74,590.63
Rate for Payer: Affinity Essential Plan 3&4	$74,590.63
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,151.39
Rate for Payer: Amida Care Medicaid	$33,151.39
Rate for Payer: EmblemHealth Essential Plan 1&2	$74,590.63
Rate for Payer: EmblemHealth Essential Plan 3&4	$33,151.39
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,151.39
Rate for Payer: Fidelis Qualified Health Plan	$39,781.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,151.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,151.39
Rate for Payer: Healthfirst Commercial	$16,969.00
Rate for Payer: Healthfirst Essential Plan	$74,590.63
Rate for Payer: Healthfirst QHP	$13,272.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,151.39
Rate for Payer: SOMOS Essential	$74,590.63
Rate for Payer: United Healthcare Essential Plan 1&2	$74,590.63
Rate for Payer: United Healthcare Essential Plan 3&4	$74,590.63
Rate for Payer: United Healthcare Medicaid	$33,151.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,151.39

Angina pectoris & coronary atherosclerosis

Facility

$41,413.66

Service Code	APR-DRG 1982
Min. Negotiated Rate	$6,107.00
Max. Negotiated Rate	$41,413.66
Rate for Payer: Affinity Essential Plan 1&2	$41,413.66
Rate for Payer: Affinity Essential Plan 3&4	$41,413.66
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,406.07
Rate for Payer: Amida Care Medicaid	$18,406.07
Rate for Payer: EmblemHealth Essential Plan 1&2	$41,413.66
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,406.07
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,406.07
Rate for Payer: Fidelis Qualified Health Plan	$22,087.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,406.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,406.07
Rate for Payer: Healthfirst Commercial	$10,556.00
Rate for Payer: Healthfirst Essential Plan	$41,413.66
Rate for Payer: Healthfirst QHP	$6,107.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,406.07
Rate for Payer: SOMOS Essential	$41,413.66
Rate for Payer: United Healthcare Essential Plan 1&2	$41,413.66
Rate for Payer: United Healthcare Essential Plan 3&4	$41,413.66
Rate for Payer: United Healthcare Medicaid	$18,406.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,406.07

ANIFROLUMAB-FNIA 300 MG/2ML IV SOLN

Facility

$3.00

Service Code	HCPCS J3590
Hospital Charge Code	0310304000
Hospital Revenue Code	258
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50

ANIFROLUMAB-FNIA 300 MG/2ML IV SOLN

Facility

$3.00

Service Code	HCPCS J3590
Hospital Charge Code	0310304000
Hospital Revenue Code	258
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: EmblemHealth Commercial	$1.50
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

ANTEPARTUM ENCOUNTERS FOR NON-ROUTINE AND ABNORMAL FINDINGS

Facility

$178.20

Service Code	EAPG 00768
Min. Negotiated Rate	$178.20
Max. Negotiated Rate	$178.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$178.20

ANTEPARTUM PROCEDURES

Facility

$958.12

Service Code	EAPG 00178
Min. Negotiated Rate	$958.12
Max. Negotiated Rate	$958.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$958.12

ANTHRAX VACCINE ADSORBED IM SUSP

Facility

$237.60

Service Code	NDC 6467821105
Hospital Charge Code	6467821105
Hospital Revenue Code	250
Min. Negotiated Rate	$118.80
Max. Negotiated Rate	$118.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.80

ANTHRAX VACCINE ADSORBED IM SUSP

Facility

$237.60

Service Code	NDC 6467821105
Hospital Charge Code	6467821105
Hospital Revenue Code	250
Min. Negotiated Rate	$83.16
Max. Negotiated Rate	$190.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.80
Rate for Payer: Aetna Government	$118.80
Rate for Payer: Brighton Health Commercial	$178.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.57
Rate for Payer: EmblemHealth Commercial	$118.80
Rate for Payer: Group Health Inc Commercial	$118.80
Rate for Payer: Group Health Inc Medicare	$83.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.80
Rate for Payer: Hamaspik Choice Inc Medicare	$118.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$154.44

ANTIHEMOPHILIC FACTOR-VWF 1000-2400 UNITS IV SOLR

Facility

$1.86

Service Code	HCPCS J7187
Hospital Charge Code	6383362701
Hospital Revenue Code	258
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$0.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.93

ANTIHEMOPHILIC FACTOR-VWF 1000-2400 UNITS IV SOLR

Facility

$1.86

Service Code	HCPCS J7187
Hospital Charge Code	6383361702
Hospital Revenue Code	258
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.49
Rate for Payer: Aetna Government	$1.49
Rate for Payer: Affinity Essential Plan 1&2	$1.04
Rate for Payer: Affinity Essential Plan 3&4	$1.04
Rate for Payer: Affinity Medicaid/CHP/HARP	$1.04
Rate for Payer: Brighton Health Commercial	$1.40
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.26
Rate for Payer: Elderplan Medicare Advantage	$1.49
Rate for Payer: EmblemHealth Commercial	$1.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.34
Rate for Payer: Fidelis Essential Plan Aliesa	$1.27
Rate for Payer: Fidelis Essential Plan QHP	$1.33
Rate for Payer: Fidelis Medicare Advantage	$1.49
Rate for Payer: Fidelis Qualified Health Plan	$1.33
Rate for Payer: Group Health Inc Commercial	$1.49
Rate for Payer: Group Health Inc Medicare	$1.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.49
Rate for Payer: Hamaspik Choice Inc Medicare	$1.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.49
Rate for Payer: Healthfirst Medicare Advantage	$1.27
Rate for Payer: Healthfirst QHP	$1.49
Rate for Payer: Humana Medicare	$1.52
Rate for Payer: Senior Whole Health Medicare Advantage	$1.49
Rate for Payer: United Healthcare Medicare Advantage	$1.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1.42
Rate for Payer: Wellcare Medicare	$1.42

ANTIHEMOPHILIC FACTOR-VWF 1000-2400 UNITS IV SOLR

Facility

$1.86

Service Code	HCPCS J7187
Hospital Charge Code	6383361702
Hospital Revenue Code	258
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$0.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.93

ANTIHEMOPHILIC FACTOR-VWF 1000-2400 UNITS IV SOLR

Facility

$1.86

Service Code	HCPCS J7187
Hospital Charge Code	6383362701
Hospital Revenue Code	258
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.49
Rate for Payer: Aetna Government	$1.49
Rate for Payer: Affinity Essential Plan 1&2	$1.04
Rate for Payer: Affinity Essential Plan 3&4	$1.04
Rate for Payer: Affinity Medicaid/CHP/HARP	$1.04
Rate for Payer: Brighton Health Commercial	$1.40
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.26
Rate for Payer: Elderplan Medicare Advantage	$1.49
Rate for Payer: EmblemHealth Commercial	$1.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.34
Rate for Payer: Fidelis Essential Plan Aliesa	$1.27
Rate for Payer: Fidelis Essential Plan QHP	$1.33
Rate for Payer: Fidelis Medicare Advantage	$1.49
Rate for Payer: Fidelis Qualified Health Plan	$1.33
Rate for Payer: Group Health Inc Commercial	$1.49
Rate for Payer: Group Health Inc Medicare	$1.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.49
Rate for Payer: Hamaspik Choice Inc Medicare	$1.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.49
Rate for Payer: Healthfirst Medicare Advantage	$1.27
Rate for Payer: Healthfirst QHP	$1.49
Rate for Payer: Humana Medicare	$1.52
Rate for Payer: Senior Whole Health Medicare Advantage	$1.49
Rate for Payer: United Healthcare Medicare Advantage	$1.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1.42
Rate for Payer: Wellcare Medicare	$1.42

APIXABAN 2.5 MG PO TABS

Facility

$11.89

Service Code	NDC 0003089321
Hospital Charge Code	0003089321
Hospital Revenue Code	250
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$5.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.94

APIXABAN 2.5 MG PO TABS

Facility

$11.89

Service Code	NDC 0003089321
Hospital Charge Code	0003089321
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$9.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.94
Rate for Payer: Aetna Government	$5.94
Rate for Payer: Brighton Health Commercial	$8.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.08
Rate for Payer: EmblemHealth Commercial	$5.94
Rate for Payer: Group Health Inc Commercial	$5.94
Rate for Payer: Group Health Inc Medicare	$4.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.94
Rate for Payer: Hamaspik Choice Inc Medicare	$5.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.73

APIXABAN 2.5 MG PO TABS

Facility

$11.89

Service Code	NDC 0003089331
Hospital Charge Code	0003089331
Hospital Revenue Code	250
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$5.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.94

APIXABAN 2.5 MG PO TABS

Facility

$11.89

Service Code	NDC 0003089331
Hospital Charge Code	0003089331
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$9.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.94
Rate for Payer: Aetna Government	$5.94
Rate for Payer: Brighton Health Commercial	$8.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.08
Rate for Payer: EmblemHealth Commercial	$5.94
Rate for Payer: Group Health Inc Commercial	$5.94
Rate for Payer: Group Health Inc Medicare	$4.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.94
Rate for Payer: Hamaspik Choice Inc Medicare	$5.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.73

APIXABAN 5 MG PO TABS

Facility

$11.89

Service Code	NDC 0003089421
Hospital Charge Code	0003089421
Hospital Revenue Code	250
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$5.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.94

APIXABAN 5 MG PO TABS

Facility

$11.89

Service Code	NDC 0003089421
Hospital Charge Code	0003089421
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$9.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.94
Rate for Payer: Aetna Government	$5.94
Rate for Payer: Brighton Health Commercial	$8.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.08
Rate for Payer: EmblemHealth Commercial	$5.94
Rate for Payer: Group Health Inc Commercial	$5.94
Rate for Payer: Group Health Inc Medicare	$4.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.94
Rate for Payer: Hamaspik Choice Inc Medicare	$5.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.73

APIXABAN 5 MG PO TABS

Facility

$11.89

Service Code	NDC 0003089431
Hospital Charge Code	0003089431
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$9.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.94
Rate for Payer: Aetna Government	$5.94
Rate for Payer: Brighton Health Commercial	$8.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.08
Rate for Payer: EmblemHealth Commercial	$5.94
Rate for Payer: Group Health Inc Commercial	$5.94
Rate for Payer: Group Health Inc Medicare	$4.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.94
Rate for Payer: Hamaspik Choice Inc Medicare	$5.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.73

Know your out-of-pocket cost for care.

All Charges