St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DOXEPIN HCL 50 MG PO CAPS [2612]

Facility

$1.33

Service Code	NDC 00904705461
Hospital Charge Code	00904705461
Hospital Revenue Code	250
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$1.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.67
Rate for Payer: Aetna Government	$0.67
Rate for Payer: Brighton Health Commercial	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.91
Rate for Payer: Group Health Inc Commercial	$0.67
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.87

DOXERCALCIFEROL 2MCG/1ML INJ.

Facility

$12.00

Service Code	HCPCS J1270
Hospital Charge Code	41647041
Hospital Revenue Code	636
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6.00

DOXERCALCIFEROL 2MCG/1ML INJ.

Facility

$12.00

Service Code	HCPCS J1270
Hospital Charge Code	41647041
Hospital Revenue Code	636
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.41
Rate for Payer: Aetna Government	$0.41
Rate for Payer: Brighton Health Commercial	$7.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.90
Rate for Payer: Group Health Inc Commercial	$6.00
Rate for Payer: Group Health Inc Medicare	$4.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.89
Rate for Payer: SOMOS Essential	$0.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.80

DOXERCALCIFEROL 2MCG/1ML INJ.

Facility

$12.00

Hospital Charge Code	41657041
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$9.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.00
Rate for Payer: Aetna Government	$6.00
Rate for Payer: Brighton Health Commercial	$9.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.16
Rate for Payer: Group Health Inc Commercial	$6.00
Rate for Payer: Group Health Inc Medicare	$4.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.80

DOXERCALCIFEROL 2 MCG/ML INJ

Facility

$5.84

Service Code	HCPCS J1270
Hospital Charge Code	41644664
Hospital Revenue Code	636
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$3.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.41
Rate for Payer: Aetna Government	$0.41
Rate for Payer: Brighton Health Commercial	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.36
Rate for Payer: Group Health Inc Commercial	$2.92
Rate for Payer: Group Health Inc Medicare	$2.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.92
Rate for Payer: Hamaspik Choice Inc Medicare	$2.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.89
Rate for Payer: SOMOS Essential	$0.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.80

DOXERCALCIFEROL 2 MCG/ML INJ

Facility

$5.84

Service Code	HCPCS J1270
Hospital Charge Code	41654664
Hospital Revenue Code	636
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$3.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.41
Rate for Payer: Aetna Government	$0.41
Rate for Payer: Brighton Health Commercial	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.36
Rate for Payer: Group Health Inc Commercial	$2.92
Rate for Payer: Group Health Inc Medicare	$2.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.92
Rate for Payer: Hamaspik Choice Inc Medicare	$2.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.89
Rate for Payer: SOMOS Essential	$0.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.80

DOXERCALCIFEROL 2 MCG/ML INJ

Facility

$5.84

Service Code	HCPCS J1270
Hospital Charge Code	41644664
Hospital Revenue Code	636
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$2.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.92
Rate for Payer: Hamaspik Choice Inc Medicare	$2.92

DOXERCALCIFEROL 2 MCG/ML INJ

Facility

$5.84

Service Code	HCPCS J1270
Hospital Charge Code	41654664
Hospital Revenue Code	636
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$2.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.92
Rate for Payer: Hamaspik Choice Inc Medicare	$2.92

DOXERCALCIFEROL 4 MCG/2ML IV SOLN [28277]

Facility

$2.44

Service Code	HCPCS J1270
Hospital Charge Code	00409133001
Hospital Revenue Code	278
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.22
Rate for Payer: Hamaspik Choice Inc Medicare	$1.22

DOXERCALCIFEROL 4 MCG/2ML IV SOLN [28277]

Facility

$2.44

Service Code	HCPCS J1270
Hospital Charge Code	00409133001
Hospital Revenue Code	278
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$2.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.41
Rate for Payer: Aetna Government	$0.41
Rate for Payer: Brighton Health Commercial	$1.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.40
Rate for Payer: EmblemHealth Commercial	$1.22
Rate for Payer: Fidelis Medicare Advantage	$2.56
Rate for Payer: Group Health Inc Commercial	$1.22
Rate for Payer: Group Health Inc Medicare	$0.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.22
Rate for Payer: Hamaspik Choice Inc Medicare	$1.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.58

DOXERCALCIFEROL 4 MCG/2ML IV SOLN [28277]

Facility

$2.44

Service Code	HCPCS J1270
Hospital Charge Code	00409133011
Hospital Revenue Code	278
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$2.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.41
Rate for Payer: Aetna Government	$0.41
Rate for Payer: Brighton Health Commercial	$1.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.40
Rate for Payer: EmblemHealth Commercial	$1.22
Rate for Payer: Fidelis Medicare Advantage	$2.56
Rate for Payer: Group Health Inc Commercial	$1.22
Rate for Payer: Group Health Inc Medicare	$0.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.22
Rate for Payer: Hamaspik Choice Inc Medicare	$1.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.58

DOXERCALCIFEROL 4 MCG/2ML IV SOLN [28277]

Facility

$2.44

Service Code	HCPCS J1270
Hospital Charge Code	00409133011
Hospital Revenue Code	278
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.22
Rate for Payer: Hamaspik Choice Inc Medicare	$1.22

DOXORUBICIN 10 MG/5 ML INJ

Facility

$8.94

Service Code	HCPCS J9000
Hospital Charge Code	41643036
Hospital Revenue Code	636
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47

DOXORUBICIN 10 MG/5 ML INJ

Facility

$8.94

Service Code	HCPCS J9000
Hospital Charge Code	41653036
Hospital Revenue Code	636
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$5.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Brighton Health Commercial	$5.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.14
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

DOXORUBICIN 10 MG/5 ML INJ

Facility

$8.94

Service Code	HCPCS J9000
Hospital Charge Code	41643036
Hospital Revenue Code	636
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$5.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Brighton Health Commercial	$5.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.14
Rate for Payer: Group Health Inc Commercial	$4.47
Rate for Payer: Group Health Inc Medicare	$3.13
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.81

DOXORUBICIN 10 MG/5 ML INJ

Facility

$8.94

Service Code	HCPCS J9000
Hospital Charge Code	41653036
Hospital Revenue Code	636
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.47
Rate for Payer: Hamaspik Choice Inc Medicare	$4.47

DOXORUBICIN 200 MG/100 ML INJ

Facility

$4.84

Service Code	HCPCS J9000
Hospital Charge Code	41644760
Hospital Revenue Code	636
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$2.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.42
Rate for Payer: Hamaspik Choice Inc Medicare	$2.42

DOXORUBICIN 200 MG/100 ML INJ

Facility

$4.84

Service Code	HCPCS J9000
Hospital Charge Code	41654760
Hospital Revenue Code	636
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$2.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.42
Rate for Payer: Hamaspik Choice Inc Medicare	$2.42

DOXORUBICIN 200 MG/100 ML INJ

Facility

$4.84

Service Code	HCPCS J9000
Hospital Charge Code	41644760
Hospital Revenue Code	636
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$3.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Brighton Health Commercial	$2.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.78
Rate for Payer: Group Health Inc Commercial	$2.42
Rate for Payer: Group Health Inc Medicare	$1.69
Rate for Payer: Hamaspik Choice Inc Medicare	$2.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.15

DOXORUBICIN 200 MG/100 ML INJ

Facility

$4.84

Service Code	HCPCS J9000
Hospital Charge Code	41654760
Hospital Revenue Code	636
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$3.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Brighton Health Commercial	$2.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.78
Rate for Payer: Group Health Inc Commercial	$2.42
Rate for Payer: Group Health Inc Medicare	$1.69
Rate for Payer: Hamaspik Choice Inc Medicare	$2.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.15

DOXORUBICIN 50 MG/25 ML INJ

Facility

$4.12

Service Code	HCPCS J9000
Hospital Charge Code	41654946
Hospital Revenue Code	636
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.06
Rate for Payer: Hamaspik Choice Inc Medicare	$2.06

DOXORUBICIN 50 MG/25 ML INJ

Facility

$4.12

Service Code	HCPCS J9000
Hospital Charge Code	41644946
Hospital Revenue Code	636
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.06
Rate for Payer: Hamaspik Choice Inc Medicare	$2.06

DOXORUBICIN 50 MG/25 ML INJ

Facility

$4.12

Service Code	HCPCS J9000
Hospital Charge Code	41644946
Hospital Revenue Code	636
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$2.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Brighton Health Commercial	$2.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.37
Rate for Payer: Group Health Inc Commercial	$2.06
Rate for Payer: Group Health Inc Medicare	$1.44
Rate for Payer: Hamaspik Choice Inc Medicare	$2.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.68

DOXORUBICIN 50 MG/25 ML INJ

Facility

$4.12

Service Code	HCPCS J9000
Hospital Charge Code	41654946
Hospital Revenue Code	636
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$2.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Brighton Health Commercial	$2.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.37
Rate for Payer: Group Health Inc Commercial	$2.06
Rate for Payer: Group Health Inc Medicare	$1.44
Rate for Payer: Hamaspik Choice Inc Medicare	$2.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.68

DOXORUBICIN 50 MG INJ

Facility

$4.84

Service Code	HCPCS J9000
Hospital Charge Code	41643586
Hospital Revenue Code	636
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$2.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.42
Rate for Payer: Hamaspik Choice Inc Medicare	$2.42

Know your out-of-pocket cost for care.

All Charges