St. Barnabas Hospital

All Charges

Charge

Type

Price

FENTANYL CITRATE 100MCG/2ML

Facility IP

$2.40

Service Code	HCPCS J3010
Hospital Charge Code	41656092
Hospital Revenue Code	636
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20

FENTANYL CITRATE 100MCG/2ML

Facility OP

$2.40

Service Code	HCPCS J3010
Hospital Charge Code	41646092
Hospital Revenue Code	636
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$1.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.32
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	$1.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.75
Rate for Payer: Group Health Inc Commercial	$1.20
Rate for Payer: Group Health Inc Medicare	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20
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	$1.56

FENTANYL CITRATE 100MCG/2ML

Facility OP

$2.40

Service Code	HCPCS J3010
Hospital Charge Code	41656092
Hospital Revenue Code	636
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$1.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.32
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	$1.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.75
Rate for Payer: Group Health Inc Commercial	$1.20
Rate for Payer: Group Health Inc Medicare	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20
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	$1.56

FENTANYL CITRATE 100MCG/2ML

Facility IP

$2.40

Service Code	HCPCS J3010
Hospital Charge Code	41646092
Hospital Revenue Code	636
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20

FENTANYL CITRATE INJ 50MCG/ML

Facility IP

$0.28

Service Code	HCPCS J3010
Hospital Charge Code	41646038
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 CITRATE INJ 50MCG/ML

Facility OP

$0.28

Service Code	HCPCS J3010
Hospital Charge Code	41646038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$1.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
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	$0.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.75
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: 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	$0.18

FENTANYL CITRATE INJ 50MCG/ML

Facility IP

$0.28

Service Code	HCPCS J3010
Hospital Charge Code	41656038
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 CITRATE INJ 50MCG/ML

Facility OP

$0.28

Service Code	HCPCS J3010
Hospital Charge Code	41656038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$1.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
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	$0.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.75
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: 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	$0.18

FENTANYL D5WW 100ML INF

Facility OP

$0.08

Hospital Charge Code	41657781
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: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
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

FENTANYL DRIP 500 MCG/D5W INFUSION 100 M

Facility OP

$7.00

Hospital Charge Code	41640088
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

FENTANYL DRIP 500 MCG/D5W INFUSION 100 M

Facility OP

$7.00

Hospital Charge Code	41650088
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

FENTANYL PATCH 100 MCG/HR

Facility OP

$22.65

Hospital Charge Code	41643946
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$18.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.32
Rate for Payer: Aetna Government	$11.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.40
Rate for Payer: Group Health Inc Commercial	$11.32
Rate for Payer: Group Health Inc Medicare	$7.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.32
Rate for Payer: Hamaspik Choice Inc Medicare	$11.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.72

FENTANYL PATCH 100 MCG/HR

Facility OP

$22.65

Hospital Charge Code	41653946
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$18.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.32
Rate for Payer: Aetna Government	$11.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.40
Rate for Payer: Group Health Inc Commercial	$11.32
Rate for Payer: Group Health Inc Medicare	$7.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.32
Rate for Payer: Hamaspik Choice Inc Medicare	$11.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.72

FENTANYL PATCH 12 MCG/HR

Facility OP

$29.68

Hospital Charge Code	41655319
Hospital Revenue Code	250
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$23.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.84
Rate for Payer: Aetna Government	$14.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.18
Rate for Payer: Group Health Inc Commercial	$14.84
Rate for Payer: Group Health Inc Medicare	$10.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.84
Rate for Payer: Hamaspik Choice Inc Medicare	$14.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$19.29

FENTANYL PATCH 12 MCG/HR

Facility OP

$29.68

Hospital Charge Code	41645319
Hospital Revenue Code	250
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$23.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.84
Rate for Payer: Aetna Government	$14.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.18
Rate for Payer: Group Health Inc Commercial	$14.84
Rate for Payer: Group Health Inc Medicare	$10.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.84
Rate for Payer: Hamaspik Choice Inc Medicare	$14.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$19.29

FENTANYL PATCH 25 MCG/HR

Facility OP

$6.48

Hospital Charge Code	41653943
Hospital Revenue Code	250
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$5.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.24
Rate for Payer: Aetna Government	$3.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.41
Rate for Payer: Group Health Inc Commercial	$3.24
Rate for Payer: Group Health Inc Medicare	$2.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.24
Rate for Payer: Hamaspik Choice Inc Medicare	$3.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.21

FENTANYL PATCH 25 MCG/HR

Facility OP

$6.48

Hospital Charge Code	41643943
Hospital Revenue Code	250
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$5.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.24
Rate for Payer: Aetna Government	$3.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.41
Rate for Payer: Group Health Inc Commercial	$3.24
Rate for Payer: Group Health Inc Medicare	$2.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.24
Rate for Payer: Hamaspik Choice Inc Medicare	$3.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.21

FENTANYL PATCH 50 MCG/HR

Facility OP

$11.00

Hospital Charge Code	41653944
Hospital Revenue Code	250
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$8.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.50
Rate for Payer: Aetna Government	$5.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.48
Rate for Payer: Group Health Inc Commercial	$5.50
Rate for Payer: Group Health Inc Medicare	$3.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.15

FENTANYL PATCH 50 MCG/HR

Facility OP

$11.00

Hospital Charge Code	41643944
Hospital Revenue Code	250
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$8.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.50
Rate for Payer: Aetna Government	$5.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.48
Rate for Payer: Group Health Inc Commercial	$5.50
Rate for Payer: Group Health Inc Medicare	$3.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.15

FENTANYL PATCH 75 MCG/HR

Facility OP

$19.11

Hospital Charge Code	41643945
Hospital Revenue Code	250
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$15.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.56
Rate for Payer: Aetna Government	$9.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.99
Rate for Payer: Group Health Inc Commercial	$9.56
Rate for Payer: Group Health Inc Medicare	$6.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.56
Rate for Payer: Hamaspik Choice Inc Medicare	$9.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.42

FENTANYL PATCH 75 MCG/HR

Facility OP

$19.11

Hospital Charge Code	41653945
Hospital Revenue Code	250
Min. Negotiated Rate	$6.69
Max. Negotiated Rate	$15.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.56
Rate for Payer: Aetna Government	$9.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.99
Rate for Payer: Group Health Inc Commercial	$9.56
Rate for Payer: Group Health Inc Medicare	$6.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.56
Rate for Payer: Hamaspik Choice Inc Medicare	$9.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.42

FENTANYL PCA 1000 MCG/D5W INFUSION 100 M

Facility OP

$11.00

Hospital Charge Code	41650619
Hospital Revenue Code	250
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$8.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.50
Rate for Payer: Aetna Government	$5.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.48
Rate for Payer: Group Health Inc Commercial	$5.50
Rate for Payer: Group Health Inc Medicare	$3.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.15

FENTANYL PCA 1000 MCG/D5W INFUSION 100 M

Facility OP

$11.00

Hospital Charge Code	41640619
Hospital Revenue Code	250
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$8.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.50
Rate for Payer: Aetna Government	$5.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.48
Rate for Payer: Group Health Inc Commercial	$5.50
Rate for Payer: Group Health Inc Medicare	$3.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.15

FENTANYL, URINE

Facility OP

$89.42

Service Code	HCPCS 80361
Hospital Charge Code	40601237
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$71.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.18
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	$71.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.81
Rate for Payer: Group Health Inc Commercial	$44.71
Rate for Payer: Group Health Inc Medicare	$31.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.71
Rate for Payer: Hamaspik Choice Inc Medicare	$44.71

FENWAL SINGLE BLOOD PACK 450ML

Facility OP

$28.50

Hospital Charge Code	64905492
Hospital Revenue Code	270
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$22.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.25
Rate for Payer: Aetna Government	$14.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.38
Rate for Payer: Group Health Inc Commercial	$14.25
Rate for Payer: Group Health Inc Medicare	$9.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.25
Rate for Payer: Hamaspik Choice Inc Medicare	$14.25

Price Transparency.

All Charges