St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CLINDAMYCIN 300 MG/2 ML INJ

Facility

$3.36

Service Code	HCPCS J3490
Hospital Charge Code	41644155
Hospital Revenue Code	636
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$2.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$2.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.93
Rate for Payer: Group Health Inc Commercial	$1.68
Rate for Payer: Group Health Inc Medicare	$1.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.18

CLINDAMYCIN 300 MG/2 ML INJ

Facility

$3.36

Service Code	HCPCS J3490
Hospital Charge Code	41644155
Hospital Revenue Code	636
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1.68

CLINDAMYCIN 300 MG/2 ML INJ

Facility

$3.36

Service Code	HCPCS J3490
Hospital Charge Code	41654155
Hospital Revenue Code	636
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$2.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$2.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.93
Rate for Payer: Group Health Inc Commercial	$1.68
Rate for Payer: Group Health Inc Medicare	$1.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.18

CLINDAMYCIN 300 MG/2 ML INJ

Facility

$3.36

Service Code	HCPCS J3490
Hospital Charge Code	41654155
Hospital Revenue Code	636
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1.68

CLINDAMYCIN 300 MG/D5W 50 ML IVPB PREMIX

Facility

$15.12

Service Code	HCPCS S0077
Hospital Charge Code	41643044
Hospital Revenue Code	636
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$9.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.17
Rate for Payer: Aetna Government	$1.17
Rate for Payer: Brighton Health Commercial	$9.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.69
Rate for Payer: Group Health Inc Commercial	$7.56
Rate for Payer: Group Health Inc Medicare	$5.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.56
Rate for Payer: Hamaspik Choice Inc Medicare	$7.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.83

CLINDAMYCIN 300 MG/D5W 50 ML IVPB PREMIX

Facility

$15.12

Service Code	HCPCS S0077
Hospital Charge Code	41653044
Hospital Revenue Code	636
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$7.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.56
Rate for Payer: Hamaspik Choice Inc Medicare	$7.56

CLINDAMYCIN 300 MG/D5W 50 ML IVPB PREMIX

Facility

$15.12

Service Code	HCPCS S0077
Hospital Charge Code	41653044
Hospital Revenue Code	636
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$9.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.17
Rate for Payer: Aetna Government	$1.17
Rate for Payer: Brighton Health Commercial	$9.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.69
Rate for Payer: Group Health Inc Commercial	$7.56
Rate for Payer: Group Health Inc Medicare	$5.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.56
Rate for Payer: Hamaspik Choice Inc Medicare	$7.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.83

CLINDAMYCIN 300 MG/D5W 50 ML IVPB PREMIX

Facility

$15.12

Service Code	HCPCS S0077
Hospital Charge Code	41643044
Hospital Revenue Code	636
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$7.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.56
Rate for Payer: Hamaspik Choice Inc Medicare	$7.56

CLINDAMYCIN 600MG 4ML PER ML/MG

Facility

$0.54

Service Code	HCPCS J7040
Hospital Charge Code	41651456
Hospital Revenue Code	636
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$1.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.30
Rate for Payer: Aetna Government	$1.30
Rate for Payer: Brighton Health Commercial	$0.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.38
Rate for Payer: SOMOS Essential	$1.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.35

CLINDAMYCIN 600MG 4ML PER ML/MG

Facility

$0.54

Service Code	HCPCS J7040
Hospital Charge Code	41651456
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27

CLINDAMYCIN 600MG 4ML, PER ML/MG

Facility

$0.54

Service Code	HCPCS J7040
Hospital Charge Code	41641456
Hospital Revenue Code	636
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$1.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.30
Rate for Payer: Aetna Government	$1.30
Rate for Payer: Brighton Health Commercial	$0.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.38
Rate for Payer: SOMOS Essential	$1.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.35

CLINDAMYCIN 600MG 4ML, PER ML/MG

Facility

$0.54

Service Code	HCPCS J7040
Hospital Charge Code	41641456
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27

CLINDAMYCIN 600 MG/D5W 50 ML IVPB PREMIX

Facility

$26.23

Service Code	HCPCS J3490
Hospital Charge Code	41641898
Hospital Revenue Code	636
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$17.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.12
Rate for Payer: Aetna Government	$13.12
Rate for Payer: Brighton Health Commercial	$15.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.08
Rate for Payer: Group Health Inc Commercial	$13.12
Rate for Payer: Group Health Inc Medicare	$9.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.12
Rate for Payer: Hamaspik Choice Inc Medicare	$13.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.05

CLINDAMYCIN 600 MG/D5W 50 ML IVPB PREMIX

Facility

$26.23

Service Code	HCPCS J3490
Hospital Charge Code	41651898
Hospital Revenue Code	636
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$13.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.12
Rate for Payer: Hamaspik Choice Inc Medicare	$13.12

CLINDAMYCIN 600 MG/D5W 50 ML IVPB PREMIX

Facility

$26.23

Service Code	HCPCS J3490
Hospital Charge Code	41641898
Hospital Revenue Code	636
Min. Negotiated Rate	$13.12
Max. Negotiated Rate	$13.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.12
Rate for Payer: Hamaspik Choice Inc Medicare	$13.12

CLINDAMYCIN 600 MG/D5W 50 ML IVPB PREMIX

Facility

$26.23

Service Code	HCPCS J3490
Hospital Charge Code	41651898
Hospital Revenue Code	636
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$17.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.12
Rate for Payer: Aetna Government	$13.12
Rate for Payer: Brighton Health Commercial	$15.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.08
Rate for Payer: Group Health Inc Commercial	$13.12
Rate for Payer: Group Health Inc Medicare	$9.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.12
Rate for Payer: Hamaspik Choice Inc Medicare	$13.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.05

CLINDAMYCIN 6 MG/ML INJ PEDIATRIC

Facility

$1.00

Hospital Charge Code	41654164
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: Brighton Health Commercial	$0.75
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

CLINDAMYCIN 6 MG/ML INJ PEDIATRIC

Facility

$1.00

Hospital Charge Code	41644164
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: Brighton Health Commercial	$0.75
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

CLINDAMYCIN 900 MG/6 ML VIAL

Facility

$7.12

Service Code	HCPCS J3490
Hospital Charge Code	41657040
Hospital Revenue Code	636
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$4.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.56
Rate for Payer: Aetna Government	$3.56
Rate for Payer: Brighton Health Commercial	$4.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.09
Rate for Payer: Group Health Inc Commercial	$3.56
Rate for Payer: Group Health Inc Medicare	$2.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.56
Rate for Payer: Hamaspik Choice Inc Medicare	$3.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.63

CLINDAMYCIN 900 MG/6 ML VIAL

Facility

$7.12

Service Code	HCPCS J3490
Hospital Charge Code	41657040
Hospital Revenue Code	636
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$3.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.56
Rate for Payer: Hamaspik Choice Inc Medicare	$3.56

CLINDAMYCIN 900MG/6 ML VIAL

Facility

$7.12

Service Code	HCPCS J3490
Hospital Charge Code	41647040
Hospital Revenue Code	636
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$4.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.56
Rate for Payer: Aetna Government	$3.56
Rate for Payer: Brighton Health Commercial	$4.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.09
Rate for Payer: Group Health Inc Commercial	$3.56
Rate for Payer: Group Health Inc Medicare	$2.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.56
Rate for Payer: Hamaspik Choice Inc Medicare	$3.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.63

CLINDAMYCIN 900MG/6 ML VIAL

Facility

$7.12

Service Code	HCPCS J3490
Hospital Charge Code	41647040
Hospital Revenue Code	636
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$3.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.56
Rate for Payer: Hamaspik Choice Inc Medicare	$3.56

CLINDAMYCIN 900 MG/D5W 50 ML IVPB PREMIX

Facility

$32.06

Service Code	HCPCS J3490
Hospital Charge Code	41640456
Hospital Revenue Code	636
Min. Negotiated Rate	$11.22
Max. Negotiated Rate	$20.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.03
Rate for Payer: Aetna Government	$16.03
Rate for Payer: Brighton Health Commercial	$19.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.43
Rate for Payer: Group Health Inc Commercial	$16.03
Rate for Payer: Group Health Inc Medicare	$11.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.03
Rate for Payer: Hamaspik Choice Inc Medicare	$16.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.84

CLINDAMYCIN 900 MG/D5W 50 ML IVPB PREMIX

Facility

$32.06

Service Code	HCPCS J3490
Hospital Charge Code	41650456
Hospital Revenue Code	636
Min. Negotiated Rate	$16.03
Max. Negotiated Rate	$16.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.03
Rate for Payer: Hamaspik Choice Inc Medicare	$16.03

CLINDAMYCIN 900 MG/D5W 50 ML IVPB PREMIX

Facility

$32.06

Service Code	HCPCS J3490
Hospital Charge Code	41650456
Hospital Revenue Code	636
Min. Negotiated Rate	$11.22
Max. Negotiated Rate	$20.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.03
Rate for Payer: Aetna Government	$16.03
Rate for Payer: Brighton Health Commercial	$19.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.43
Rate for Payer: Group Health Inc Commercial	$16.03
Rate for Payer: Group Health Inc Medicare	$11.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.03
Rate for Payer: Hamaspik Choice Inc Medicare	$16.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.84

Know your out-of-pocket cost for care.

All Charges