St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ENOXAPARIN 100 MG/ML INJ

Facility

$14.92

Service Code	HCPCS J1650
Hospital Charge Code	41642062
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
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: Brighton Health Commercial	$8.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.58
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: 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

$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

$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

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41642742
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
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: Brighton Health Commercial	$2.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.96
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: 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

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41652742
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
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: Brighton Health Commercial	$2.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.96
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: 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

$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

$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 150 MG/ML INJ

Facility

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41642743
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
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: Brighton Health Commercial	$3.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.61
Rate for Payer: 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: 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

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41652743
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
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: Brighton Health Commercial	$3.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.61
Rate for Payer: 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: 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 30 MG/0.3 ML INJ

Facility

$1.71

Service Code	HCPCS J1650
Hospital Charge Code	41650151
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

ENOXAPARIN 30 MG/0.3 ML INJ

Facility

$1.71

Service Code	HCPCS J1650
Hospital Charge Code	41640151
Hospital Revenue Code	636
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$1.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Brighton Health Commercial	$1.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.98
Rate for Payer: Group Health Inc Commercial	$0.86
Rate for Payer: Group Health Inc Medicare	$0.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.86
Rate for Payer: Hamaspik Choice Inc Medicare	$0.86
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	$1.11

ENOXAPARIN 30 MG/0.3 ML INJ

Facility

$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

ENOXAPARIN 30 MG/0.3 ML INJ

Facility

$1.71

Service Code	HCPCS J1650
Hospital Charge Code	41650151
Hospital Revenue Code	636
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$1.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Brighton Health Commercial	$1.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.98
Rate for Payer: Group Health Inc Commercial	$0.86
Rate for Payer: Group Health Inc Medicare	$0.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.86
Rate for Payer: Hamaspik Choice Inc Medicare	$0.86
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	$1.11

ENOXAPARIN 40 MG/0.4 ML INJ

Facility

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41652482
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 40 MG/0.4 ML INJ

Facility

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41652482
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
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: Brighton Health Commercial	$2.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.96
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: 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 40 MG/0.4 ML INJ

Facility

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41642482
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 40 MG/0.4 ML INJ

Facility

$3.41

Service Code	HCPCS J1650
Hospital Charge Code	41642482
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
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: Brighton Health Commercial	$2.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.96
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: 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 60 MG/0.6 ML INJ

Facility

$14.89

Service Code	HCPCS J1650
Hospital Charge Code	41642483
Hospital Revenue Code	636
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$7.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.44
Rate for Payer: Hamaspik Choice Inc Medicare	$7.44

ENOXAPARIN 60 MG/0.6 ML INJ

Facility

$14.89

Service Code	HCPCS J1650
Hospital Charge Code	41652483
Hospital Revenue Code	636
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$7.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.44
Rate for Payer: Hamaspik Choice Inc Medicare	$7.44

ENOXAPARIN 60 MG/0.6 ML INJ

Facility

$14.89

Service Code	HCPCS J1650
Hospital Charge Code	41642483
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$9.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Brighton Health Commercial	$8.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.56
Rate for Payer: Group Health Inc Commercial	$7.44
Rate for Payer: Group Health Inc Medicare	$5.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.44
Rate for Payer: Hamaspik Choice Inc Medicare	$7.44
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	$9.68

ENOXAPARIN 60 MG/0.6 ML INJ

Facility

$14.89

Service Code	HCPCS J1650
Hospital Charge Code	41652483
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$9.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Brighton Health Commercial	$8.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.56
Rate for Payer: Group Health Inc Commercial	$7.44
Rate for Payer: Group Health Inc Medicare	$5.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.44
Rate for Payer: Hamaspik Choice Inc Medicare	$7.44
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	$9.68

ENOXAPARIN 80 MG/0.8 ML INJ

Facility

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41652074
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
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: Brighton Health Commercial	$3.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.61
Rate for Payer: 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: 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 80 MG/0.8 ML INJ

Facility

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41642074
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 80 MG/0.8 ML INJ

Facility

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41642074
Hospital Revenue Code	636
Min. Negotiated Rate	$0.66
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: Brighton Health Commercial	$3.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.61
Rate for Payer: 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: 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 80 MG/0.8 ML INJ

Facility

$6.27

Service Code	HCPCS J1650
Hospital Charge Code	41652074
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

Know your out-of-pocket cost for care.

All Charges