St. Barnabas Hospital

All Charges

Charge

Type

Price

CHRONOS (TM) GRANULES-LG 10CC

Facility OP

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	40200222
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,680.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$880.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$800.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$920.00
Rate for Payer: Fidelis Medicare Advantage	$1,680.00
Rate for Payer: Group Health Inc Commercial	$800.00
Rate for Payer: Group Health Inc Medicare	$560.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$800.00
Rate for Payer: Hamaspik Choice Inc Medicare	$800.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,040.00

CHRONOS (TM) GRANULES-LG 10CC

Facility IP

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	40200222
Hospital Revenue Code	278
Min. Negotiated Rate	$800.00
Max. Negotiated Rate	$800.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$800.00
Rate for Payer: Hamaspik Choice Inc Medicare	$800.00

CHUCK FOR PINS HOFF

Facility OP

$1,865.50

Service Code	HCPCS C1776
Hospital Charge Code	64907452
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,958.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,026.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$932.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,072.66
Rate for Payer: Fidelis Medicare Advantage	$1,958.78
Rate for Payer: Group Health Inc Commercial	$932.75
Rate for Payer: Group Health Inc Medicare	$652.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$932.75
Rate for Payer: Hamaspik Choice Inc Medicare	$932.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,212.58

CHUCK FOR PINS HOFF

Facility IP

$1,865.50

Service Code	HCPCS C1776
Hospital Charge Code	64907452
Hospital Revenue Code	278
Min. Negotiated Rate	$932.75
Max. Negotiated Rate	$932.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$932.75
Rate for Payer: Hamaspik Choice Inc Medicare	$932.75

CHUCKS (UNDERPAD)

Facility OP

$12.05

Hospital Charge Code	40201080
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$9.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.02
Rate for Payer: Aetna Government	$6.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.19
Rate for Payer: Group Health Inc Commercial	$6.02
Rate for Payer: Group Health Inc Medicare	$4.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.02
Rate for Payer: Hamaspik Choice Inc Medicare	$6.02

CH VEIN HOOK A

Facility OP

$493.75

Hospital Charge Code	64903616
Hospital Revenue Code	270
Min. Negotiated Rate	$172.81
Max. Negotiated Rate	$395.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$271.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$246.88
Rate for Payer: Aetna Government	$246.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$395.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$335.75
Rate for Payer: Group Health Inc Commercial	$246.88
Rate for Payer: Group Health Inc Medicare	$172.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$246.88
Rate for Payer: Hamaspik Choice Inc Medicare	$246.88

CH VEIN HOOK B

Facility OP

$493.75

Hospital Charge Code	64903618
Hospital Revenue Code	270
Min. Negotiated Rate	$172.81
Max. Negotiated Rate	$395.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$271.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$246.88
Rate for Payer: Aetna Government	$246.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$395.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$335.75
Rate for Payer: Group Health Inc Commercial	$246.88
Rate for Payer: Group Health Inc Medicare	$172.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$246.88
Rate for Payer: Hamaspik Choice Inc Medicare	$246.88

CINACALCET 30 MG TAB

Facility IP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41643862
Hospital Revenue Code	636
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56

CINACALCET 30 MG TAB

Facility IP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41653862
Hospital Revenue Code	636
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56

CINACALCET 30 MG TAB

Facility OP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41643862
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.79
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.03

CINACALCET 30 MG TAB

Facility OP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41653862
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.79
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.03

CINACALCET 60 MG TAB

Facility IP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41654681
Hospital Revenue Code	636
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56

CINACALCET 60 MG TAB

Facility OP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41644681
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.79
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.03

CINACALCET 60 MG TAB

Facility OP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41654681
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.79
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.03

CINACALCET 60 MG TAB

Facility IP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41644681
Hospital Revenue Code	636
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56

CINACALCET 90 MG TAB

Facility IP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41644682
Hospital Revenue Code	636
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56

CINACALCET 90 MG TAB

Facility OP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41644682
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.79
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.03

CINACALCET 90 MG TAB

Facility IP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41654682
Hospital Revenue Code	636
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56

CINACALCET 90 MG TAB

Facility OP

$3.12

Service Code	HCPCS J0604
Hospital Charge Code	41654682
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.79
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.03

CIPROFLOXACIN 200 MG/100 ML IVPB PREMIX

Facility OP

$2.28

Service Code	HCPCS J0744
Hospital Charge Code	41654252
Hospital Revenue Code	636
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$1.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.08
Rate for Payer: Aetna Government	$1.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.76
Rate for Payer: Group Health Inc Commercial	$1.14
Rate for Payer: Group Health Inc Medicare	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.97
Rate for Payer: SOMOS Essential	$1.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.48

CIPROFLOXACIN 200 MG/100 ML IVPB PREMIX

Facility IP

$2.28

Service Code	HCPCS J0744
Hospital Charge Code	41654252
Hospital Revenue Code	636
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1.14

CIPROFLOXACIN 200 MG/100 ML IVPB PREMIX

Facility OP

$2.28

Service Code	HCPCS J0744
Hospital Charge Code	41644252
Hospital Revenue Code	636
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$1.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.08
Rate for Payer: Aetna Government	$1.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.76
Rate for Payer: Group Health Inc Commercial	$1.14
Rate for Payer: Group Health Inc Medicare	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.97
Rate for Payer: SOMOS Essential	$1.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.48

CIPROFLOXACIN 200 MG/100 ML IVPB PREMIX

Facility IP

$2.28

Service Code	HCPCS J0744
Hospital Charge Code	41644252
Hospital Revenue Code	636
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1.14

CIPROFLOXACIN 250 MG/5 ML SUSP

Facility OP

$2.00

Hospital Charge Code	41644374
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

CIPROFLOXACIN 250 MG/5 ML SUSP

Facility OP

$2.00

Hospital Charge Code	41654374
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

Price Transparency.

All Charges