St. Barnabas Hospital

All Charges

Charge

Type

Price

CIPROFLOXACIN 250 MG TAB

Facility OP

$0.25

Hospital Charge Code	41643694
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.17
Rate for Payer: Group Health Inc Commercial	$0.13
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.16

CIPROFLOXACIN 250 MG TAB

Facility OP

$0.25

Hospital Charge Code	41653694
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.17
Rate for Payer: Group Health Inc Commercial	$0.13
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.16

CIPROFLOXACIN 2 MG/ML INJ PEDIATRIC

Facility OP

$4.00

Hospital Charge Code	41641584
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

CIPROFLOXACIN 2 MG/ML INJ PEDIATRIC

Facility OP

$4.00

Hospital Charge Code	41651584
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

CIPROFLOXACIN 400 MG/200 ML IVPB PREMIX

Facility OP

$1.81

Service Code	HCPCS J0744
Hospital Charge Code	41654375
Hospital Revenue Code	636
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$1.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.00
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	$0.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.04
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.76
Rate for Payer: Group Health Inc Commercial	$0.91
Rate for Payer: Group Health Inc Medicare	$0.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.91
Rate for Payer: Hamaspik Choice Inc Medicare	$0.91
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	$1.18

CIPROFLOXACIN 400 MG/200 ML IVPB PREMIX

Facility IP

$1.81

Service Code	HCPCS J0744
Hospital Charge Code	41654375
Hospital Revenue Code	636
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.91
Rate for Payer: Hamaspik Choice Inc Medicare	$0.91

CIPROFLOXACIN 400 MG/200 ML IVPB PREMIX

Facility IP

$1.81

Service Code	HCPCS J0744
Hospital Charge Code	41644375
Hospital Revenue Code	636
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.91
Rate for Payer: Hamaspik Choice Inc Medicare	$0.91

CIPROFLOXACIN 400 MG/200 ML IVPB PREMIX

Facility OP

$1.81

Service Code	HCPCS J0744
Hospital Charge Code	41644375
Hospital Revenue Code	636
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$1.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.00
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	$0.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.04
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.76
Rate for Payer: Group Health Inc Commercial	$0.91
Rate for Payer: Group Health Inc Medicare	$0.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.91
Rate for Payer: Hamaspik Choice Inc Medicare	$0.91
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	$1.18

CIPROFLOXACIN 500 MG TAB

Facility OP

$1.00

Hospital Charge Code	41654707
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

CIPROFLOXACIN 500 MG TAB

Facility OP

$1.00

Hospital Charge Code	41644707
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

CIPROFLOXACIN 750 MG TAB

Facility OP

$0.77

Hospital Charge Code	41643696
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.39
Rate for Payer: Aetna Government	$0.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.52
Rate for Payer: Group Health Inc Commercial	$0.39
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39
Rate for Payer: Hamaspik Choice Inc Medicare	$0.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.50

CIPROFLOXACIN 750 MG TAB

Facility OP

$0.77

Hospital Charge Code	41653696
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.39
Rate for Payer: Aetna Government	$0.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.52
Rate for Payer: Group Health Inc Commercial	$0.39
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39
Rate for Payer: Hamaspik Choice Inc Medicare	$0.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.50

CIRCLIPS HMRS

Facility OP

$1,140.00

Service Code	HCPCS C1776
Hospital Charge Code	64907251
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,197.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$627.00
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	$570.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$655.50
Rate for Payer: Fidelis Medicare Advantage	$1,197.00
Rate for Payer: Group Health Inc Commercial	$570.00
Rate for Payer: Group Health Inc Medicare	$399.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$570.00
Rate for Payer: Hamaspik Choice Inc Medicare	$570.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$741.00

CIRCLIPS HMRS

Facility IP

$1,140.00

Service Code	HCPCS C1776
Hospital Charge Code	64907251
Hospital Revenue Code	278
Min. Negotiated Rate	$570.00
Max. Negotiated Rate	$570.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$570.00
Rate for Payer: Hamaspik Choice Inc Medicare	$570.00

CIRCUIT ANESTHESIA ADULT

Facility OP

$9.47

Hospital Charge Code	64902258
Hospital Revenue Code	270
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$7.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.74
Rate for Payer: Aetna Government	$4.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.44
Rate for Payer: Group Health Inc Commercial	$4.74
Rate for Payer: Group Health Inc Medicare	$3.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.74
Rate for Payer: Hamaspik Choice Inc Medicare	$4.74

CIRCUIT DISPOSABLE IVENT 201

Facility OP

$23.40

Hospital Charge Code	64902510
Hospital Revenue Code	270
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$18.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.70
Rate for Payer: Aetna Government	$11.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.91
Rate for Payer: Group Health Inc Commercial	$11.70
Rate for Payer: Group Health Inc Medicare	$8.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.70
Rate for Payer: Hamaspik Choice Inc Medicare	$11.70

CIRCUIT INFANT HEATED 4FT RESP

Facility OP

$19.88

Service Code	HCPCS C1776
Hospital Charge Code	64902411
Hospital Revenue Code	278
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.93
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	$9.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.43
Rate for Payer: Fidelis Medicare Advantage	$20.87
Rate for Payer: Group Health Inc Commercial	$9.94
Rate for Payer: Group Health Inc Medicare	$6.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.94
Rate for Payer: Hamaspik Choice Inc Medicare	$9.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.92

CIRCUIT INFANT HEATED 4FT RESP

Facility IP

$19.88

Service Code	HCPCS C1776
Hospital Charge Code	64902411
Hospital Revenue Code	278
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$9.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.94
Rate for Payer: Hamaspik Choice Inc Medicare	$9.94

CIRCUIT,PEDIATRIC

Facility OP

$14.99

Hospital Charge Code	64903976
Hospital Revenue Code	270
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$11.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.50
Rate for Payer: Aetna Government	$7.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.19
Rate for Payer: Group Health Inc Commercial	$7.50
Rate for Payer: Group Health Inc Medicare	$5.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.50
Rate for Payer: Hamaspik Choice Inc Medicare	$7.50

CIRCUIT PEDIATRIC 75

Facility OP

$682.83

Hospital Charge Code	64903694
Hospital Revenue Code	270
Min. Negotiated Rate	$238.99
Max. Negotiated Rate	$546.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$375.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$341.42
Rate for Payer: Aetna Government	$341.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$546.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$464.32
Rate for Payer: Group Health Inc Commercial	$341.42
Rate for Payer: Group Health Inc Medicare	$238.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$341.42
Rate for Payer: Hamaspik Choice Inc Medicare	$341.42

CIRCUIT,VENT,48,NEONA,DUAL HEA

Facility OP

$19.09

Hospital Charge Code	64901743
Hospital Revenue Code	270
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$15.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.54
Rate for Payer: Aetna Government	$9.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.98
Rate for Payer: Group Health Inc Commercial	$9.54
Rate for Payer: Group Health Inc Medicare	$6.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.54
Rate for Payer: Hamaspik Choice Inc Medicare	$9.54

CIRCUIT VENTILATOR

Facility OP

$5.50

Hospital Charge Code	64902250
Hospital Revenue Code	270
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$4.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.75
Rate for Payer: Aetna Government	$2.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.74
Rate for Payer: Group Health Inc Commercial	$2.75
Rate for Payer: Group Health Inc Medicare	$1.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2.75

CIRCUIT VENT MONITORING W/ADAPTER

Facility OP

$2.88

Hospital Charge Code	64902167
Hospital Revenue Code	270
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$2.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.44
Rate for Payer: Aetna Government	$1.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.96
Rate for Payer: Group Health Inc Commercial	$1.44
Rate for Payer: Group Health Inc Medicare	$1.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1.44

CIRCUIT VENT PB7200A

Facility OP

$5.95

Hospital Charge Code	64901883
Hospital Revenue Code	270
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$4.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.98
Rate for Payer: Aetna Government	$2.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.05
Rate for Payer: Group Health Inc Commercial	$2.98
Rate for Payer: Group Health Inc Medicare	$2.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.98
Rate for Payer: Hamaspik Choice Inc Medicare	$2.98

CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC

Facility IP

$37,964.79

Service Code	MS-DRG 286
Min. Negotiated Rate	$17,307.48
Max. Negotiated Rate	$37,964.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31,784.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37,220.38
Rate for Payer: Aetna Government	$37,220.38
Rate for Payer: Brighton Health Commercial	$31,256.20
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$37,964.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37,225.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$30,719.71
Rate for Payer: Elderplan Medicare Advantage	$35,359.36
Rate for Payer: EmblemHealth Commercial	$18,484.30
Rate for Payer: Fidelis Medicare Advantage	$37,220.38
Rate for Payer: Group Health Inc Commercial	$37,220.38
Rate for Payer: Group Health Inc Medicare	$37,220.38
Rate for Payer: Hamaspik Choice Inc Medicare	$37,220.38
Rate for Payer: Healthfirst Medicare Advantage	$17,307.48
Rate for Payer: Senior Whole Health Medicare Advantage	$37,220.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$37,220.38
Rate for Payer: Wellcare Medicare	$35,359.36

Price Transparency.

All Charges