St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BACTERIOSTATIC WATER(BENZ ALC) IJ SOLN

Facility

$0.07

Service Code	NDC 0409397703
Hospital Charge Code	0409397703
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
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	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: EmblemHealth Commercial	$0.04
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

BACTERIOSTATIC WATER(BENZ ALC) IJ SOLN

Facility

$0.07

Service Code	NDC 0409397703
Hospital Charge Code	0409397703
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04

BAMLANIVIMAB 700 MG/20ML IV SOLN

Facility

$0.00

Service Code	NDC 0002791001
Hospital Charge Code	0002791001
Hospital Revenue Code	258
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.00

BAMLANIVIMAB 700 MG/20ML IV SOLN

Facility

$0.00

Service Code	NDC 0002791001
Hospital Charge Code	0002791001
Hospital Revenue Code	258
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.00
Rate for Payer: Aetna Government	$0.00
Rate for Payer: Brighton Health Commercial	$0.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.00
Rate for Payer: EmblemHealth Commercial	$0.00
Rate for Payer: Group Health Inc Commercial	$0.00
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.00
Rate for Payer: Hamaspik Choice Inc Medicare	$0.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.00

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290974603
Hospital Charge Code	3290974603
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290974103
Hospital Charge Code	3290974103
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290974203
Hospital Charge Code	3290974203
Hospital Revenue Code	250
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: EmblemHealth Commercial	$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

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290974403
Hospital Charge Code	3290974403
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290974603
Hospital Charge Code	3290974603
Hospital Revenue Code	250
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: EmblemHealth Commercial	$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

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290971103
Hospital Charge Code	3290971103
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290974103
Hospital Charge Code	3290974103
Hospital Revenue Code	250
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: EmblemHealth Commercial	$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

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290974403
Hospital Charge Code	3290974403
Hospital Revenue Code	250
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: EmblemHealth Commercial	$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

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290974203
Hospital Charge Code	3290974203
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

BARIUM SULFATE 2 % PO SUSP

Facility

$0.01

Service Code	NDC 3290971103
Hospital Charge Code	3290971103
Hospital Revenue Code	250
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: EmblemHealth Commercial	$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

BARIUM SULFATE 96 % PO SUSR

Facility

$0.03

Service Code	NDC 3290975003
Hospital Charge Code	3290975003
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

BARIUM SULFATE 96 % PO SUSR

Facility

$0.03

Service Code	NDC 3290975003
Hospital Charge Code	3290975003
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
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	$0.02

BARIUM SULFATE 98 % PO SUSR

Facility

$7.94

Service Code	NDC 3290976401
Hospital Charge Code	3290976401
Hospital Revenue Code	250
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$6.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.97
Rate for Payer: Aetna Government	$3.97
Rate for Payer: Brighton Health Commercial	$5.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.40
Rate for Payer: EmblemHealth Commercial	$3.97
Rate for Payer: Group Health Inc Commercial	$3.97
Rate for Payer: Group Health Inc Medicare	$2.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.97
Rate for Payer: Hamaspik Choice Inc Medicare	$3.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.16

BARIUM SULFATE 98 % PO SUSR

Facility

$7.94

Service Code	NDC 3290976401
Hospital Charge Code	3290976401
Hospital Revenue Code	250
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$3.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.97

BASIC CHEMISTRY TESTS

Facility

$13.32

Service Code	EAPG 00402
Min. Negotiated Rate	$9.26
Max. Negotiated Rate	$13.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.26
Rate for Payer: Healthfirst Commercial	$13.32

BCG LIVE 50 MG IS SUSR

Facility

$196.02

Service Code	HCPCS J9030
Hospital Charge Code	0052060202
Hospital Revenue Code	250
Min. Negotiated Rate	$98.01
Max. Negotiated Rate	$98.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.01

BCG LIVE 50 MG IS SUSR

Facility

$196.02

Service Code	HCPCS J9030
Hospital Charge Code	0052060202
Hospital Revenue Code	250
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$156.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.85
Rate for Payer: Aetna Government	$2.85
Rate for Payer: Brighton Health Commercial	$147.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$156.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$133.29
Rate for Payer: EmblemHealth Commercial	$98.01
Rate for Payer: Group Health Inc Commercial	$98.01
Rate for Payer: Group Health Inc Medicare	$68.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.01
Rate for Payer: Hamaspik Choice Inc Medicare	$98.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.41

BECLOMETHASONE DIPROP HFA 40 MCG/ACT IN AERB

Facility

$24.19

Service Code	NDC 5931030240
Hospital Charge Code	5931030240
Hospital Revenue Code	250
Min. Negotiated Rate	$8.47
Max. Negotiated Rate	$19.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.10
Rate for Payer: Aetna Government	$12.10
Rate for Payer: Brighton Health Commercial	$18.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.45
Rate for Payer: EmblemHealth Commercial	$12.10
Rate for Payer: Group Health Inc Commercial	$12.10
Rate for Payer: Group Health Inc Medicare	$8.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.10
Rate for Payer: Hamaspik Choice Inc Medicare	$12.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.72

BECLOMETHASONE DIPROP HFA 40 MCG/ACT IN AERB

Facility

$24.19

Service Code	NDC 5931030240
Hospital Charge Code	5931030240
Hospital Revenue Code	250
Min. Negotiated Rate	$12.10
Max. Negotiated Rate	$12.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.10

BECLOMETHASONE DIPROPIONATE 80 MCG/ACT NA AERS

Facility

$34.46

Service Code	NDC 5931041012
Hospital Charge Code	5931041012
Hospital Revenue Code	250
Min. Negotiated Rate	$17.23
Max. Negotiated Rate	$17.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.23

BECLOMETHASONE DIPROPIONATE 80 MCG/ACT NA AERS

Facility

$34.46

Service Code	NDC 5931041012
Hospital Charge Code	5931041012
Hospital Revenue Code	250
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$27.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.23
Rate for Payer: Aetna Government	$17.23
Rate for Payer: Brighton Health Commercial	$25.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.43
Rate for Payer: EmblemHealth Commercial	$17.23
Rate for Payer: Group Health Inc Commercial	$17.23
Rate for Payer: Group Health Inc Medicare	$12.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.23
Rate for Payer: Hamaspik Choice Inc Medicare	$17.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.40

Know your out-of-pocket cost for care.

All Charges