St. Barnabas Hospital

All Charges

Charge

Type

Price

ENFAMIL PREMATURE HIGH PROTEIN 24

Facility OP

$0.45

Hospital Charge Code	41640253
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23

ENFAMIL PREMATURE HIGH PROTEIN 24

Facility OP

$0.45

Hospital Charge Code	41650253
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23

ENFAMIL PRMATURE IRON FORTIFED 20

Facility OP

$0.45

Hospital Charge Code	41650256
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23

ENFAMIL PRMATURE IRON FORTIFED 20

Facility OP

$0.45

Hospital Charge Code	41640256
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23

ENFAMIL PRMATURE IRON FORTIFED 24

Facility OP

$0.45

Hospital Charge Code	41640259
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23

ENFAMIL PRMATURE IRON FORTIFED 24

Facility OP

$0.45

Hospital Charge Code	41650259
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23

ENFIT 10ML SYRINGE

Facility OP

$120.00

Hospital Charge Code	64903714
Hospital Revenue Code	270
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$96.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.00
Rate for Payer: Aetna Government	$60.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$96.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.60
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00

ENFUVIRTIDE 90 MG/ML INJ

Facility IP

$83.00

Service Code	HCPCS J3490
Hospital Charge Code	41653763
Hospital Revenue Code	636
Min. Negotiated Rate	$41.50
Max. Negotiated Rate	$41.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.50
Rate for Payer: Hamaspik Choice Inc Medicare	$41.50

ENFUVIRTIDE 90 MG/ML INJ

Facility OP

$83.00

Service Code	HCPCS J3490
Hospital Charge Code	41653763
Hospital Revenue Code	636
Min. Negotiated Rate	$29.05
Max. Negotiated Rate	$53.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.50
Rate for Payer: Aetna Government	$41.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.72
Rate for Payer: Group Health Inc Commercial	$41.50
Rate for Payer: Group Health Inc Medicare	$29.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.50
Rate for Payer: Hamaspik Choice Inc Medicare	$41.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$53.95

ENFUVIRTIDE 90 MG/ML INJ

Facility IP

$83.00

Service Code	HCPCS J3490
Hospital Charge Code	41643763
Hospital Revenue Code	636
Min. Negotiated Rate	$41.50
Max. Negotiated Rate	$41.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.50
Rate for Payer: Hamaspik Choice Inc Medicare	$41.50

ENFUVIRTIDE 90 MG/ML INJ

Facility OP

$83.00

Service Code	HCPCS J3490
Hospital Charge Code	41643763
Hospital Revenue Code	636
Min. Negotiated Rate	$29.05
Max. Negotiated Rate	$53.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.50
Rate for Payer: Aetna Government	$41.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.72
Rate for Payer: Group Health Inc Commercial	$41.50
Rate for Payer: Group Health Inc Medicare	$29.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.50
Rate for Payer: Hamaspik Choice Inc Medicare	$41.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$53.95

ENIR MANIPULATION COMPL CARE

Facility OP

$57.70

Service Code	HCPCS 99499
Hospital Charge Code	30400245
Hospital Revenue Code	510
Min. Negotiated Rate	$28.85
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.85
Rate for Payer: Aetna Government	$28.85
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	$28.85
Rate for Payer: Hamaspik Choice Inc Medicare	$28.85

ENOXAPARIN 100 MG/ML INJ

Facility OP

$14.92

Service Code	HCPCS J1650
Hospital Charge Code	41652062
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$9.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.61
Rate for Payer: Group Health Inc Commercial	$7.46
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.46
Rate for Payer: Hamaspik Choice Inc Medicare	$7.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.66
Rate for Payer: SOMOS Essential	$0.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.70

ENOXAPARIN 100 MG/ML INJ

Facility IP

$14.92

Service Code	HCPCS J1650
Hospital Charge Code	41652062
Hospital Revenue Code	636
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$7.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.46
Rate for Payer: Hamaspik Choice Inc Medicare	$7.46

ENOXAPARIN 100 MG/ML INJ

Facility IP

$14.92

Service Code	HCPCS J1650
Hospital Charge Code	41642062
Hospital Revenue Code	636
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$7.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.46
Rate for Payer: Hamaspik Choice Inc Medicare	$7.46

ENOXAPARIN 100 MG/ML INJ

Facility OP

$14.92

Service Code	HCPCS J1650
Hospital Charge Code	41642062
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$9.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.61
Rate for Payer: Group Health Inc Commercial	$7.46
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.46
Rate for Payer: Hamaspik Choice Inc Medicare	$7.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.66
Rate for Payer: SOMOS Essential	$0.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.70

ENOXAPARIN 120 MG/0.8 ML INJ

Facility IP

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41652742
Hospital Revenue Code	636
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70

ENOXAPARIN 120 MG/0.8 ML INJ

Facility IP

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41642742
Hospital Revenue Code	636
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70

ENOXAPARIN 120 MG/0.8 ML INJ

Facility OP

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41642742
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$2.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.96
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.61
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.66
Rate for Payer: SOMOS Essential	$0.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.22

ENOXAPARIN 120 MG/0.8 ML INJ

Facility OP

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41652742
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$2.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.96
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.61
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.66
Rate for Payer: SOMOS Essential	$0.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.22

ENOXAPARIN 150 MG/ML INJ

Facility OP

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41642743
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$4.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.61
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.61
Rate for Payer: Group Health Inc Commercial	$3.14
Rate for Payer: Group Health Inc Medicare	$2.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.14
Rate for Payer: Hamaspik Choice Inc Medicare	$3.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.66
Rate for Payer: SOMOS Essential	$0.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.08

ENOXAPARIN 150 MG/ML INJ

Facility IP

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41652743
Hospital Revenue Code	636
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$3.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.14
Rate for Payer: Hamaspik Choice Inc Medicare	$3.14

ENOXAPARIN 150 MG/ML INJ

Facility OP

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41652743
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$4.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.61
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.61
Rate for Payer: Group Health Inc Commercial	$3.14
Rate for Payer: Group Health Inc Medicare	$2.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.14
Rate for Payer: Hamaspik Choice Inc Medicare	$3.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.66
Rate for Payer: SOMOS Essential	$0.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.08

ENOXAPARIN 150 MG/ML INJ

Facility IP

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41642743
Hospital Revenue Code	636
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$3.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.14
Rate for Payer: Hamaspik Choice Inc Medicare	$3.14

ENOXAPARIN 30 MG/0.3 ML INJ

Facility IP

$1.71

Service Code	HCPCS J1650
Hospital Charge Code	41640151
Hospital Revenue Code	636
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.86
Rate for Payer: Hamaspik Choice Inc Medicare	$0.86

Price Transparency.

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