St. Barnabas Hospital

All Charges

Charge

Type

Price

FENTANYL 1000MCG/NS 200ML INF

Facility OP

$16.00

Hospital Charge Code	41657179
Hospital Revenue Code	250
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$12.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.00
Rate for Payer: Aetna Government	$8.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.88
Rate for Payer: Group Health Inc Commercial	$8.00
Rate for Payer: Group Health Inc Medicare	$5.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.00
Rate for Payer: Hamaspik Choice Inc Medicare	$8.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.40

FENTANYL 10 MCG/ML INJ PEDIATRIC

Facility OP

$1.00

Hospital Charge Code	41644637
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: 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

FENTANYL 10 MCG/ML INJ PEDIATRIC

Facility OP

$1.00

Hospital Charge Code	41654637
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: 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

FENTANYL 2500MCG/50ML - .1MG VIAL

Facility IP

$0.01

Service Code	HCPCS J3010
Hospital Charge Code	41658413
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

FENTANYL 2500MCG/50ML - .1MG VIAL

Facility OP

$0.01

Service Code	HCPCS J3010
Hospital Charge Code	41658413
Hospital Revenue Code	636
Max. Negotiated Rate	$1.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.63
Rate for Payer: Aetna Government	$0.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.75
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: Healthfirst CHP/FHP/Medicaid	$0.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.05
Rate for Payer: SOMOS Essential	$1.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

FENTANYL 2500MCG/50ML - .1MG VIAL

Facility IP

$0.01

Service Code	HCPCS J3010
Hospital Charge Code	41648413
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

FENTANYL 2500MCG/50ML - .1MG VIAL

Facility OP

$0.01

Service Code	HCPCS J3010
Hospital Charge Code	41648413
Hospital Revenue Code	636
Max. Negotiated Rate	$1.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.63
Rate for Payer: Aetna Government	$0.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.75
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: Healthfirst CHP/FHP/Medicaid	$0.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.05
Rate for Payer: SOMOS Essential	$1.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

FENTANYL 250MG 50ML INF PEDS

Facility OP

$6.00

Hospital Charge Code	41657180
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

FENTANYL 250MG 50ML INF PEDS

Facility OP

$6.00

Hospital Charge Code	41647180
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

FENTANYL 50 MCG/ML INJ 10 ML

Facility IP

$0.84

Hospital Charge Code	41644421
Hospital Revenue Code	636
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42

FENTANYL 50 MCG/ML INJ 10 ML

Facility OP

$0.84

Hospital Charge Code	41654421
Hospital Revenue Code	636
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.48
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.55

FENTANYL 50 MCG/ML INJ 10 ML

Facility IP

$0.84

Hospital Charge Code	41654421
Hospital Revenue Code	636
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42

FENTANYL 50 MCG/ML INJ 10 ML

Facility OP

$0.84

Hospital Charge Code	41644421
Hospital Revenue Code	636
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.48
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.55

FENTANYL 50 MCG/ML INJ 20 ML

Facility OP

$0.28

Hospital Charge Code	41655599
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

FENTANYL 50 MCG/ML INJ 20 ML

Facility OP

$0.28

Hospital Charge Code	41645599
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

FENTANYL 50 MCG/ML INJ 20 ML

Facility IP

$0.28

Hospital Charge Code	41645599
Hospital Revenue Code	636
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14

FENTANYL 50 MCG/ML INJ 20 ML

Facility IP

$0.28

Hospital Charge Code	41655599
Hospital Revenue Code	636
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14

FENTANYL 50 MCG/ML INJ 2 ML AMP

Facility OP

$8.44

Service Code	HCPCS J3010
Hospital Charge Code	41654345
Hospital Revenue Code	636
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$5.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.63
Rate for Payer: Aetna Government	$0.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.85
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.75
Rate for Payer: Group Health Inc Commercial	$4.22
Rate for Payer: Group Health Inc Medicare	$2.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.22
Rate for Payer: Hamaspik Choice Inc Medicare	$4.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.05
Rate for Payer: SOMOS Essential	$1.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.49

FENTANYL 50 MCG/ML INJ 2 ML AMP

Facility OP

$8.44

Hospital Charge Code	41644345
Hospital Revenue Code	250
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$6.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.22
Rate for Payer: Aetna Government	$4.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.74
Rate for Payer: Group Health Inc Commercial	$4.22
Rate for Payer: Group Health Inc Medicare	$2.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.22
Rate for Payer: Hamaspik Choice Inc Medicare	$4.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.49

FENTANYL 50 MCG/ML INJ 2 ML AMP

Facility IP

$8.44

Service Code	HCPCS J3010
Hospital Charge Code	41654345
Hospital Revenue Code	636
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$4.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.22
Rate for Payer: Hamaspik Choice Inc Medicare	$4.22

FENTANYL 50 MCG/ML INJ 2 ML VIAL

Facility OP

$44.20

Hospital Charge Code	41645566
Hospital Revenue Code	636
Min. Negotiated Rate	$15.47
Max. Negotiated Rate	$28.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.10
Rate for Payer: Aetna Government	$22.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.42
Rate for Payer: Group Health Inc Commercial	$22.10
Rate for Payer: Group Health Inc Medicare	$15.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.10
Rate for Payer: Hamaspik Choice Inc Medicare	$22.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.73

FENTANYL 50 MCG/ML INJ 2 ML VIAL

Facility OP

$44.20

Hospital Charge Code	41655566
Hospital Revenue Code	636
Min. Negotiated Rate	$15.47
Max. Negotiated Rate	$28.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.10
Rate for Payer: Aetna Government	$22.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.42
Rate for Payer: Group Health Inc Commercial	$22.10
Rate for Payer: Group Health Inc Medicare	$15.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.10
Rate for Payer: Hamaspik Choice Inc Medicare	$22.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.73

FENTANYL 50 MCG/ML INJ 2 ML VIAL

Facility IP

$44.20

Hospital Charge Code	41645566
Hospital Revenue Code	636
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$22.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.10
Rate for Payer: Hamaspik Choice Inc Medicare	$22.10

FENTANYL 50 MCG/ML INJ 2 ML VIAL

Facility IP

$44.20

Hospital Charge Code	41655566
Hospital Revenue Code	636
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$22.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.10
Rate for Payer: Hamaspik Choice Inc Medicare	$22.10

FENTANYL AND ANALOGUES

Facility OP

$87.50

Service Code	HCPCS 80354
Hospital Charge Code	40609880
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$70.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.12
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	$70.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.50
Rate for Payer: Group Health Inc Commercial	$43.75
Rate for Payer: Group Health Inc Medicare	$30.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.75
Rate for Payer: Hamaspik Choice Inc Medicare	$43.75

Price Transparency.

All Charges