St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CLINIMIX E 4.25/5

Facility

$0.01

Service Code	HCPCS J3490
Hospital Charge Code	41650345
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: Brighton Health Commercial	$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

CLINIMIX E 4.25/5

Facility

$0.01

Service Code	HCPCS J3490
Hospital Charge Code	41640345
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

CLINIMIX E 4.25/5

Facility

$0.01

Service Code	HCPCS J3490
Hospital Charge Code	41650345
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

CLINIMIX E/DEXTROSE (4.25/10) 4.25 % IV SOLN [23163]

Facility

$0.05

Service Code	NDC 00338111504
Hospital Charge Code	00338111504
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02

CLINIMIX E/DEXTROSE (4.25/10) 4.25 % IV SOLN [23163]

Facility

$0.05

Service Code	NDC 00338111504
Hospital Charge Code	00338111504
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Fidelis Medicare Advantage	$0.05
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

CLINIMIX E/DEXTROSE (4.25/10) 4.25 % IV SOLN [23163]

Facility

$0.06

Service Code	NDC 00338114503
Hospital Charge Code	00338114503
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.03
Rate for Payer: Fidelis Medicare Advantage	$0.06
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.04

CLINIMIX E/DEXTROSE (4.25/10) 4.25 % IV SOLN [23163]

Facility

$0.06

Service Code	NDC 00338114503
Hospital Charge Code	00338114503
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

CLINIMIX E/DEXTROSE (4.25/5) 4.25 % IV SOLN [23162]

Facility

$0.05

Service Code	NDC 00338114403
Hospital Charge Code	00338114403
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

CLINIMIX E/DEXTROSE (4.25/5) 4.25 % IV SOLN [23162]

Facility

$0.05

Service Code	NDC 00338111304
Hospital Charge Code	00338111304
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Fidelis Medicare Advantage	$0.05
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

CLINIMIX E/DEXTROSE (4.25/5) 4.25 % IV SOLN [23162]

Facility

$0.05

Service Code	NDC 00338114403
Hospital Charge Code	00338114403
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.03
Rate for Payer: Fidelis Medicare Advantage	$0.05
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

CLINIMIX E/DEXTROSE (4.25/5) 4.25 % IV SOLN [23162]

Facility

$0.05

Service Code	NDC 00338111304
Hospital Charge Code	00338111304
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02

CLINIMIX E/DEXTROSE (5/15) 5 % IV SOLN [23165]

Facility

$0.05

Service Code	NDC 00338112304
Hospital Charge Code	00338112304
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

CLINIMIX E/DEXTROSE (5/15) 5 % IV SOLN [23165]

Facility

$0.05

Service Code	NDC 00338114703
Hospital Charge Code	00338114703
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.03
Rate for Payer: Fidelis Medicare Advantage	$0.06
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.04

CLINIMIX E/DEXTROSE (5/15) 5 % IV SOLN [23165]

Facility

$0.05

Service Code	NDC 00338112304
Hospital Charge Code	00338112304
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.03
Rate for Payer: Fidelis Medicare Advantage	$0.05
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.03

CLINIMIX E/DEXTROSE (5/15) 5 % IV SOLN [23165]

Facility

$0.05

Service Code	NDC 00338114703
Hospital Charge Code	00338114703
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

CLINIMIX E/DEXTROSE (8/10) 8 % IV SOLN [174876]

Facility

$0.08

Service Code	NDC 00338021006
Hospital Charge Code	00338021006
Hospital Revenue Code	278
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04

CLINIMIX E/DEXTROSE (8/10) 8 % IV SOLN [174876]

Facility

$0.08

Service Code	NDC 00338021006
Hospital Charge Code	00338021006
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: EmblemHealth Commercial	$0.04
Rate for Payer: Fidelis Medicare Advantage	$0.08
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

CLIN IND IMG HD TRAUMA

Facility

$0.01

Service Code	HCPCS G2187
Hospital Charge Code	30300315
Hospital Revenue Code	929
Max. Negotiated Rate	$94.00
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: Brighton Health Commercial	$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: United Healthcare Commercial	$94.00

CLINITRON BED WITH UPLIFT

Facility

$163.01

Hospital Charge Code	40209100
Hospital Revenue Code	270
Min. Negotiated Rate	$57.05
Max. Negotiated Rate	$130.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$81.50
Rate for Payer: Aetna Government	$81.50
Rate for Payer: Brighton Health Commercial	$122.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$130.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$110.85
Rate for Payer: Group Health Inc Commercial	$81.50
Rate for Payer: Group Health Inc Medicare	$57.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.50
Rate for Payer: Hamaspik Choice Inc Medicare	$81.50

CLINITRON BED W/UPLIFT AUTOCHARGE

Facility

$163.01

Hospital Charge Code	40209101
Hospital Revenue Code	270
Min. Negotiated Rate	$57.05
Max. Negotiated Rate	$130.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$81.50
Rate for Payer: Aetna Government	$81.50
Rate for Payer: Brighton Health Commercial	$122.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$130.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$110.85
Rate for Payer: Group Health Inc Commercial	$81.50
Rate for Payer: Group Health Inc Medicare	$57.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.50
Rate for Payer: Hamaspik Choice Inc Medicare	$81.50

CLINITRON THERAPY UNIT

Facility

$251.25

Hospital Charge Code	40200921
Hospital Revenue Code	270
Min. Negotiated Rate	$87.94
Max. Negotiated Rate	$201.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$125.62
Rate for Payer: Aetna Government	$125.62
Rate for Payer: Brighton Health Commercial	$188.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$201.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$170.85
Rate for Payer: Group Health Inc Commercial	$125.62
Rate for Payer: Group Health Inc Medicare	$87.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.62
Rate for Payer: Hamaspik Choice Inc Medicare	$125.62

CLINOPID

Facility

$0.01

Hospital Charge Code	41640227
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

CLINOPID

Facility

$0.01

Hospital Charge Code	41640227
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: Brighton Health Commercial	$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

CLINOPID

Facility

$0.01

Hospital Charge Code	41650227
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

CLINOPID

Facility

$0.01

Hospital Charge Code	41650227
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: Brighton Health Commercial	$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

Know your out-of-pocket cost for care.

All Charges