St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

INSULIN LISPRO 100 UNIT/ML IJ SOLN

Facility

$7.97

Service Code	HCPCS J1815
Hospital Charge Code	0002751001
Hospital Revenue Code	250
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$3.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.98

INSULIN LISPRO 100 UNIT/ML IJ SOLN

Facility

$3.00

Service Code	HCPCS J1815
Hospital Charge Code	0002773701
Hospital Revenue Code	250
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50

INSULIN LISPRO 100 UNIT/ML IJ SOLN

Facility

$7.97

Service Code	HCPCS J1815
Hospital Charge Code	0002753301
Hospital Revenue Code	250
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$3.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.98

INSULIN LISPRO PROT & LISPRO (50-50) 100 UNIT/ML SC SUSP

Facility

$10.25

Service Code	HCPCS J1815
Hospital Charge Code	0002751201
Hospital Revenue Code	250
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$5.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.12

INSULIN LISPRO PROT & LISPRO (50-50) 100 UNIT/ML SC SUSP

Facility

$10.25

Service Code	HCPCS J1815
Hospital Charge Code	0002751201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$8.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$7.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.97
Rate for Payer: EmblemHealth Commercial	$5.12
Rate for Payer: Group Health Inc Commercial	$5.12
Rate for Payer: Group Health Inc Medicare	$3.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.12
Rate for Payer: Hamaspik Choice Inc Medicare	$5.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.66

INSULIN LISPRO PROT & LISPRO (75-25) 100 UNIT/ML SC SUSP

Facility

$10.25

Service Code	HCPCS J1815
Hospital Charge Code	0002751101
Hospital Revenue Code	250
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$5.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.12

INSULIN LISPRO PROT & LISPRO (75-25) 100 UNIT/ML SC SUSP

Facility

$10.25

Service Code	HCPCS J1815
Hospital Charge Code	0002751101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$8.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$7.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.97
Rate for Payer: EmblemHealth Commercial	$5.12
Rate for Payer: Group Health Inc Commercial	$5.12
Rate for Payer: Group Health Inc Medicare	$3.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.12
Rate for Payer: Hamaspik Choice Inc Medicare	$5.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.66

INSULIN NPH (HUMAN) (ISOPHANE) 100 UNIT/ML SC SUSP

Facility

$5.78

Service Code	HCPCS J1815
Hospital Charge Code	0169183411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$4.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$4.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.93
Rate for Payer: EmblemHealth Commercial	$2.89
Rate for Payer: Group Health Inc Commercial	$2.89
Rate for Payer: Group Health Inc Medicare	$2.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.89
Rate for Payer: Hamaspik Choice Inc Medicare	$2.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.76

INSULIN NPH (HUMAN) (ISOPHANE) 100 UNIT/ML SC SUSP

Facility

$17.84

Service Code	HCPCS J1815
Hospital Charge Code	0002831517
Hospital Revenue Code	250
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$8.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.92

INSULIN NPH (HUMAN) (ISOPHANE) 100 UNIT/ML SC SUSP

Facility

$17.84

Service Code	HCPCS J1815
Hospital Charge Code	0002831517
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$14.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$13.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.13
Rate for Payer: EmblemHealth Commercial	$8.92
Rate for Payer: Group Health Inc Commercial	$8.92
Rate for Payer: Group Health Inc Medicare	$6.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.92
Rate for Payer: Hamaspik Choice Inc Medicare	$8.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.60

INSULIN NPH (HUMAN) (ISOPHANE) 100 UNIT/ML SC SUSP

Facility

$5.35

Service Code	HCPCS J1815
Hospital Charge Code	0002831501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$4.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$4.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.64
Rate for Payer: EmblemHealth Commercial	$2.68
Rate for Payer: Group Health Inc Commercial	$2.68
Rate for Payer: Group Health Inc Medicare	$1.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68
Rate for Payer: Hamaspik Choice Inc Medicare	$2.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.48

INSULIN NPH (HUMAN) (ISOPHANE) 100 UNIT/ML SC SUSP

Facility

$5.78

Service Code	HCPCS J1815
Hospital Charge Code	0169183411
Hospital Revenue Code	250
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.89

INSULIN NPH (HUMAN) (ISOPHANE) 100 UNIT/ML SC SUSP

Facility

$5.35

Service Code	HCPCS J1815
Hospital Charge Code	0002831501
Hospital Revenue Code	250
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$2.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68

INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN

Facility

$5.35

Service Code	HCPCS J1815
Hospital Charge Code	0002821501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$4.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$4.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.64
Rate for Payer: EmblemHealth Commercial	$2.68
Rate for Payer: Group Health Inc Commercial	$2.68
Rate for Payer: Group Health Inc Medicare	$1.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68
Rate for Payer: Hamaspik Choice Inc Medicare	$2.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.48

INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN

Facility

$5.35

Service Code	HCPCS J1815
Hospital Charge Code	0002021301
Hospital Revenue Code	250
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$2.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68

INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN

Facility

$5.35

Service Code	HCPCS J1815
Hospital Charge Code	0002821501
Hospital Revenue Code	250
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$2.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68

INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN

Facility

$5.78

Service Code	HCPCS J1815
Hospital Charge Code	0169183311
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$4.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$4.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.93
Rate for Payer: EmblemHealth Commercial	$2.89
Rate for Payer: Group Health Inc Commercial	$2.89
Rate for Payer: Group Health Inc Medicare	$2.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.89
Rate for Payer: Hamaspik Choice Inc Medicare	$2.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.76

INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN

Facility

$5.78

Service Code	HCPCS J1815
Hospital Charge Code	0169183311
Hospital Revenue Code	250
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.89

INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN

Facility

$5.35

Service Code	HCPCS J1815
Hospital Charge Code	0002021301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$4.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$4.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.64
Rate for Payer: EmblemHealth Commercial	$2.68
Rate for Payer: Group Health Inc Commercial	$2.68
Rate for Payer: Group Health Inc Medicare	$1.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68
Rate for Payer: Hamaspik Choice Inc Medicare	$2.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.48

INSULIN REGULAR HUMAN (CONC) 500 UNIT/ML SC SOLN

Facility

$89.22

Service Code	HCPCS J1815
Hospital Charge Code	0002850101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$71.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$66.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.67
Rate for Payer: EmblemHealth Commercial	$44.61
Rate for Payer: Group Health Inc Commercial	$44.61
Rate for Payer: Group Health Inc Medicare	$31.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.61
Rate for Payer: Hamaspik Choice Inc Medicare	$44.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$57.99

INSULIN REGULAR HUMAN (CONC) 500 UNIT/ML SC SOLN

Facility

$89.22

Service Code	HCPCS J1815
Hospital Charge Code	0002850101
Hospital Revenue Code	250
Min. Negotiated Rate	$44.61
Max. Negotiated Rate	$44.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.61

INSULIN REGULAR(HUMAN) INFUSION PROTOCOL CALCULATOR (PREMIX)

Facility

$0.42

Service Code	NDC 0338012612
Hospital Charge Code	0338012612
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21

INSULIN REGULAR(HUMAN) INFUSION PROTOCOL CALCULATOR (PREMIX)

Facility

$0.42

Service Code	NDC 0338012612
Hospital Charge Code	0338012612
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.21
Rate for Payer: Aetna Government	$0.21
Rate for Payer: Brighton Health Commercial	$0.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.29
Rate for Payer: EmblemHealth Commercial	$0.21
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

INSULIN REGULAR(HUMAN) IN NACL 100-0.9 UT/100ML-% IV SOLN

Facility

$0.42

Service Code	NDC 0338012612
Hospital Charge Code	0338012612
Hospital Revenue Code	258
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21

INSULIN REGULAR(HUMAN) IN NACL 100-0.9 UT/100ML-% IV SOLN

Facility

$0.42

Service Code	NDC 0338012612
Hospital Charge Code	0338012612
Hospital Revenue Code	258
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.21
Rate for Payer: Aetna Government	$0.21
Rate for Payer: Brighton Health Commercial	$0.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.29
Rate for Payer: EmblemHealth Commercial	$0.21
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

Know your out-of-pocket cost for care.

All Charges