St. Barnabas Hospital

All Charges

Charge

Type

Price

COVID-19 PED VAC 6MON-5YRS PFIZER

Facility OP

$0.01

Service Code	HCPCS 91308
Hospital Charge Code	41640336
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID-19 PED VAC 6MON-5YRS PFIZER

Facility OP

$0.01

Service Code	HCPCS 91308
Hospital Charge Code	41650336
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID-19 PED VAC 6MON-5YRS PFIZER

Facility IP

$0.01

Service Code	HCPCS 91308
Hospital Charge Code	41650336
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

COVID-19 PED VAC 6MON-5YRS PFIZER

Facility IP

$0.01

Service Code	HCPCS 91308
Hospital Charge Code	41640336
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

COVID-19 VACCINE (JANSEN)

Facility IP

$0.01

Service Code	HCPCS 91303
Hospital Charge Code	41640244
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

COVID-19 VACCINE (JANSEN)

Facility OP

$0.01

Service Code	HCPCS 91303
Hospital Charge Code	41640244
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID-19 VACCINE (JANSEN)

Facility OP

$0.01

Service Code	HCPCS 91303
Hospital Charge Code	41650244
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID-19 VACCINE (JANSEN)

Facility IP

$0.01

Service Code	HCPCS 91303
Hospital Charge Code	41650244
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

COVID-19 VACCINE (MODERNA)

Facility OP

$0.01

Service Code	HCPCS 91309
Hospital Charge Code	41650198
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID-19 VACCINE (MODERNA)

Facility OP

$0.01

Service Code	HCPCS 91309
Hospital Charge Code	41640198
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID-19 VACCINE (MODERNA)

Facility IP

$0.01

Service Code	HCPCS 91309
Hospital Charge Code	41640198
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

COVID-19 VACCINE (MODERNA)

Facility IP

$0.01

Service Code	HCPCS 91309
Hospital Charge Code	41650198
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

COVID-19 VACCINE (PFIZER)

Facility OP

$0.01

Service Code	HCPCS 91300
Hospital Charge Code	41640196
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID-19 VACCINE (PFIZER)

Facility IP

$0.01

Service Code	HCPCS 91300
Hospital Charge Code	41640196
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

COVID-19 VACCINE (PFIZER)

Facility IP

$0.01

Service Code	HCPCS 91300
Hospital Charge Code	41650196
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

COVID-19 VACCINE (PFIZER)

Facility OP

$0.01

Service Code	HCPCS 91300
Hospital Charge Code	41650196
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID-19 VACCINE(PFZ TRIS SUCROS)

Facility OP

$0.01

Service Code	HCPCS 91300
Hospital Charge Code	41650290
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID-19 VACCINE(PFZ TRIS SUCROS)

Facility IP

$0.01

Service Code	HCPCS 91300
Hospital Charge Code	41640290
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

COVID-19 VACCINE(PFZ TRIS SUCROS)

Facility IP

$0.01

Service Code	HCPCS 91300
Hospital Charge Code	41650290
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

COVID-19 VACCINE(PFZ TRIS SUCROS)

Facility OP

$0.01

Service Code	HCPCS 91300
Hospital Charge Code	41640290
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

COVID COUNSEL TO UNVACCINATED

Facility OP

$62.50

Service Code	HCPCS 99429
Hospital Charge Code	30301433
Hospital Revenue Code	510
Min. Negotiated Rate	$31.25
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.25
Rate for Payer: Aetna Government	$31.25
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.25
Rate for Payer: Hamaspik Choice Inc Medicare	$31.25

COVID COUNSEL TO UNVACC-TELE

Facility OP

$62.50

Service Code	HCPCS 99429 GQ
Hospital Charge Code	30301434
Hospital Revenue Code	510
Min. Negotiated Rate	$31.25
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.25
Rate for Payer: Aetna Government	$31.25
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.25
Rate for Payer: Hamaspik Choice Inc Medicare	$31.25

COXSACKIE A IGG/IGM ANTIBODY

Facility OP

$32.58

Service Code	HCPCS 86658
Hospital Charge Code	40729359
Hospital Revenue Code	300
Min. Negotiated Rate	$10.42
Max. Negotiated Rate	$20.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.03
Rate for Payer: Aetna Government	$13.03
Rate for Payer: Cash Price	$13.03
Rate for Payer: Cash Price	$13.03
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.52
Rate for Payer: Elderplan Medicare Advantage	$13.03
Rate for Payer: EmblemHealth Commercial	$13.03
Rate for Payer: Fidelis CHP/HARP/Medicaid	$11.73
Rate for Payer: Fidelis Essential Plan Aliesa	$11.08
Rate for Payer: Fidelis Essential Plan QHP	$11.60
Rate for Payer: Fidelis Medicare Advantage	$13.03
Rate for Payer: Fidelis Qualified Health Plan	$11.60
Rate for Payer: Group Health Inc Commercial	$13.03
Rate for Payer: Group Health Inc Medicare	$13.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.29
Rate for Payer: Hamaspik Choice Inc Medicare	$13.03
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$13.03
Rate for Payer: Healthfirst Medicare Advantage	$13.03
Rate for Payer: Healthfirst QHP	$13.03
Rate for Payer: Senior Whole Health Medicare Advantage	$13.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.03
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.42
Rate for Payer: Wellcare Medicare	$11.73

COXSACKIE A VIRUS ANTIBODIES

Facility OP

$32.58

Service Code	HCPCS 86658
Hospital Charge Code	40617684
Hospital Revenue Code	300
Min. Negotiated Rate	$10.42
Max. Negotiated Rate	$20.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.03
Rate for Payer: Aetna Government	$13.03
Rate for Payer: Cash Price	$13.03
Rate for Payer: Cash Price	$13.03
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.52
Rate for Payer: Elderplan Medicare Advantage	$13.03
Rate for Payer: EmblemHealth Commercial	$13.03
Rate for Payer: Fidelis CHP/HARP/Medicaid	$11.73
Rate for Payer: Fidelis Essential Plan Aliesa	$11.08
Rate for Payer: Fidelis Essential Plan QHP	$11.60
Rate for Payer: Fidelis Medicare Advantage	$13.03
Rate for Payer: Fidelis Qualified Health Plan	$11.60
Rate for Payer: Group Health Inc Commercial	$13.03
Rate for Payer: Group Health Inc Medicare	$13.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.29
Rate for Payer: Hamaspik Choice Inc Medicare	$13.03
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$13.03
Rate for Payer: Healthfirst Medicare Advantage	$13.03
Rate for Payer: Healthfirst QHP	$13.03
Rate for Payer: Senior Whole Health Medicare Advantage	$13.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.03
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.42
Rate for Payer: Wellcare Medicare	$11.73

COXSACKIE VIRUS GROUP B AB

Facility OP

$69.93

Hospital Charge Code	40729845
Hospital Revenue Code	302
Min. Negotiated Rate	$24.48
Max. Negotiated Rate	$55.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.96
Rate for Payer: Aetna Government	$34.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.55
Rate for Payer: Group Health Inc Commercial	$34.96
Rate for Payer: Group Health Inc Medicare	$24.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.96
Rate for Payer: Hamaspik Choice Inc Medicare	$34.96

Price Transparency.

All Charges