St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DOBUTAMINE-DEXTROSE 4-5 MG/ML-% IV SOLN [18317]

Facility

$0.14

Service Code	NDC 00338107702
Hospital Charge Code	00338107702
Hospital Revenue Code	278
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Fidelis Medicare Advantage	$0.15
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

DOBUTAMINE-DEXTROSE 4-5 MG/ML-% IV SOLN [18317]

Facility

$0.09

Service Code	NDC 00409372411
Hospital Charge Code	00409372411
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
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	$0.09
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	$0.06

DOBUTAMINE HCL 12.5 MG/ML IV SOLN [9892]

Facility

$0.44

Service Code	HCPCS J1250
Hospital Charge Code	00409234401
Hospital Revenue Code	278
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$8.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$0.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.25
Rate for Payer: EmblemHealth Commercial	$0.22
Rate for Payer: Fidelis Medicare Advantage	$0.46
Rate for Payer: Group Health Inc Commercial	$0.22
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

DOBUTAMINE HCL 12.5 MG/ML IV SOLN [9892]

Facility

$0.42

Service Code	HCPCS J1250
Hospital Charge Code	00409234402
Hospital Revenue Code	278
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21

DOBUTAMINE HCL 12.5 MG/ML IV SOLN [9892]

Facility

$0.42

Service Code	HCPCS J1250
Hospital Charge Code	00409234402
Hospital Revenue Code	278
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$8.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$0.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
Rate for Payer: EmblemHealth Commercial	$0.21
Rate for Payer: Fidelis Medicare Advantage	$0.44
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.27

DOBUTAMINE HCL 12.5 MG/ML IV SOLN [9892]

Facility

$0.44

Service Code	HCPCS J1250
Hospital Charge Code	00409234401
Hospital Revenue Code	278
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22

DOBUTAMINE HCL 250 MG/20ML IV SOLN [77318]

Facility

$0.42

Service Code	HCPCS J1250
Hospital Charge Code	00409234462
Hospital Revenue Code	278
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$8.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$0.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
Rate for Payer: EmblemHealth Commercial	$0.21
Rate for Payer: Fidelis Medicare Advantage	$0.44
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.27

DOBUTAMINE HCL 250 MG/20ML IV SOLN [77318]

Facility

$0.44

Service Code	HCPCS J1250
Hospital Charge Code	00409234401
Hospital Revenue Code	278
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$8.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$0.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.25
Rate for Payer: EmblemHealth Commercial	$0.22
Rate for Payer: Fidelis Medicare Advantage	$0.46
Rate for Payer: Group Health Inc Commercial	$0.22
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

DOBUTAMINE HCL 250 MG/20ML IV SOLN [77318]

Facility

$0.44

Service Code	HCPCS J1250
Hospital Charge Code	00409234401
Hospital Revenue Code	278
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22

DOBUTAMINE HCL 250 MG/20ML IV SOLN [77318]

Facility

$0.42

Service Code	HCPCS J1250
Hospital Charge Code	00409234462
Hospital Revenue Code	278
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21

DOCETAXEL 160 MG/16ML IV SOLN [108908]

Facility

$37.76

Service Code	HCPCS J9171
Hospital Charge Code	00409020120
Hospital Revenue Code	278
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$39.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$22.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.71
Rate for Payer: EmblemHealth Commercial	$18.88
Rate for Payer: Fidelis Medicare Advantage	$39.65
Rate for Payer: Group Health Inc Commercial	$18.88
Rate for Payer: Group Health Inc Medicare	$13.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.88
Rate for Payer: Hamaspik Choice Inc Medicare	$18.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$24.54

DOCETAXEL 160 MG/16ML IV SOLN [108908]

Facility

$37.76

Service Code	HCPCS J9171
Hospital Charge Code	00409020120
Hospital Revenue Code	278
Min. Negotiated Rate	$18.88
Max. Negotiated Rate	$18.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.88
Rate for Payer: Hamaspik Choice Inc Medicare	$18.88

DOCETAXEL 160 MG/8ML IV CONC [116947]

Facility

$365.15

Service Code	HCPCS J9171
Hospital Charge Code	67457078108
Hospital Revenue Code	278
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$383.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$200.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$219.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$209.96
Rate for Payer: EmblemHealth Commercial	$182.58
Rate for Payer: Fidelis Medicare Advantage	$383.41
Rate for Payer: Group Health Inc Commercial	$182.58
Rate for Payer: Group Health Inc Medicare	$127.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$182.58
Rate for Payer: Hamaspik Choice Inc Medicare	$182.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$237.35

DOCETAXEL 160 MG/8ML IV CONC [116947]

Facility

$365.15

Service Code	HCPCS J9171
Hospital Charge Code	67457078108
Hospital Revenue Code	278
Min. Negotiated Rate	$182.58
Max. Negotiated Rate	$182.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$182.58
Rate for Payer: Hamaspik Choice Inc Medicare	$182.58

DOCETAXEL 20 MG/0.5 ML INJ

Facility

$9.33

Service Code	HCPCS J9171
Hospital Charge Code	41651739
Hospital Revenue Code	636
Min. Negotiated Rate	$4.66
Max. Negotiated Rate	$4.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.66
Rate for Payer: Hamaspik Choice Inc Medicare	$4.66

DOCETAXEL 20 MG/0.5 ML INJ

Facility

$9.33

Service Code	HCPCS J9171
Hospital Charge Code	41641739
Hospital Revenue Code	636
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$6.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$5.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.36
Rate for Payer: Group Health Inc Commercial	$4.66
Rate for Payer: Group Health Inc Medicare	$3.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.66
Rate for Payer: Hamaspik Choice Inc Medicare	$4.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.92
Rate for Payer: SOMOS Essential	$0.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.06

DOCETAXEL 20 MG/0.5 ML INJ

Facility

$9.33

Service Code	HCPCS J9171
Hospital Charge Code	41651739
Hospital Revenue Code	636
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$6.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$5.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.36
Rate for Payer: Group Health Inc Commercial	$4.66
Rate for Payer: Group Health Inc Medicare	$3.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.66
Rate for Payer: Hamaspik Choice Inc Medicare	$4.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.92
Rate for Payer: SOMOS Essential	$0.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.06

DOCETAXEL 20 MG/0.5 ML INJ

Facility

$9.33

Service Code	HCPCS J9171
Hospital Charge Code	41641739
Hospital Revenue Code	636
Min. Negotiated Rate	$4.66
Max. Negotiated Rate	$4.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.66
Rate for Payer: Hamaspik Choice Inc Medicare	$4.66

DOCETAXEL 20 MG/2ML IV SOLN [108910]

Facility

$41.25

Service Code	HCPCS J9171
Hospital Charge Code	67457053102
Hospital Revenue Code	278
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$43.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$24.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.72
Rate for Payer: EmblemHealth Commercial	$20.62
Rate for Payer: Fidelis Medicare Advantage	$43.31
Rate for Payer: Group Health Inc Commercial	$20.62
Rate for Payer: Group Health Inc Medicare	$14.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.62
Rate for Payer: Hamaspik Choice Inc Medicare	$20.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.81

DOCETAXEL 20 MG/2ML IV SOLN [108910]

Facility

$41.25

Service Code	HCPCS J9171
Hospital Charge Code	67457053102
Hospital Revenue Code	278
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.62
Rate for Payer: Hamaspik Choice Inc Medicare	$20.62

DOCETAXEL 20 MG/ML IV CONC [106443]

Facility

$83.74

Service Code	HCPCS J9171
Hospital Charge Code	00409036601
Hospital Revenue Code	278
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$87.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$50.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.15
Rate for Payer: EmblemHealth Commercial	$41.87
Rate for Payer: Fidelis Medicare Advantage	$87.93
Rate for Payer: Group Health Inc Commercial	$41.87
Rate for Payer: Group Health Inc Medicare	$29.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.87
Rate for Payer: Hamaspik Choice Inc Medicare	$41.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$54.43

DOCETAXEL 20 MG/ML IV CONC [106443]

Facility

$83.74

Service Code	HCPCS J9171
Hospital Charge Code	00409036601
Hospital Revenue Code	278
Min. Negotiated Rate	$41.87
Max. Negotiated Rate	$41.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.87
Rate for Payer: Hamaspik Choice Inc Medicare	$41.87

DOCETAXEL 20 MG/ML IV CONC [106443]

Facility

$365.15

Service Code	HCPCS J9171
Hospital Charge Code	47335032340
Hospital Revenue Code	278
Min. Negotiated Rate	$182.58
Max. Negotiated Rate	$182.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$182.58
Rate for Payer: Hamaspik Choice Inc Medicare	$182.58

DOCETAXEL 20 MG/ML IV CONC [106443]

Facility

$365.15

Service Code	HCPCS J9171
Hospital Charge Code	47335032340
Hospital Revenue Code	278
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$383.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$200.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$219.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$209.96
Rate for Payer: EmblemHealth Commercial	$182.58
Rate for Payer: Fidelis Medicare Advantage	$383.41
Rate for Payer: Group Health Inc Commercial	$182.58
Rate for Payer: Group Health Inc Medicare	$127.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$182.58
Rate for Payer: Hamaspik Choice Inc Medicare	$182.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$237.35

DOCETAXEL 80 MG/2 ML INJ

Facility

$9.35

Service Code	HCPCS J9171
Hospital Charge Code	41651740
Hospital Revenue Code	636
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$6.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$5.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.38
Rate for Payer: Group Health Inc Commercial	$4.68
Rate for Payer: Group Health Inc Medicare	$3.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.68
Rate for Payer: Hamaspik Choice Inc Medicare	$4.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.92
Rate for Payer: SOMOS Essential	$0.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.08

Know your out-of-pocket cost for care.

All Charges