St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

LEVALBUTEROL HCL 0.63 MG/3ML IN NEBU

Facility

$2.24

Service Code	HCPCS J7614
Hospital Charge Code	0093414656
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$1.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.52
Rate for Payer: EmblemHealth Commercial	$1.12
Rate for Payer: Group Health Inc Commercial	$1.12
Rate for Payer: Group Health Inc Medicare	$0.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.45

LEVALBUTEROL HCL 0.63 MG/3ML IN NEBU

Facility

$2.14

Service Code	HCPCS J7614
Hospital Charge Code	3557344425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$1.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.46
Rate for Payer: EmblemHealth Commercial	$1.07
Rate for Payer: Group Health Inc Commercial	$1.07
Rate for Payer: Group Health Inc Medicare	$0.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07
Rate for Payer: Hamaspik Choice Inc Medicare	$1.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.39

LEVALBUTEROL HCL 0.63 MG/3ML IN NEBU

Facility

$2.15

Service Code	HCPCS J7614
Hospital Charge Code	0115993178
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07

LEVALBUTEROL HCL 0.63 MG/3ML IN NEBU

Facility

$0.67

Service Code	HCPCS J7614
Hospital Charge Code	7620480001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33

LEVALBUTEROL HCL 0.63 MG/3ML IN NEBU

Facility

$2.15

Service Code	HCPCS J7614
Hospital Charge Code	0115993178
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$1.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.46
Rate for Payer: EmblemHealth Commercial	$1.07
Rate for Payer: Group Health Inc Commercial	$1.07
Rate for Payer: Group Health Inc Medicare	$0.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07
Rate for Payer: Hamaspik Choice Inc Medicare	$1.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.39

LEVALBUTEROL HCL 0.63 MG/3ML IN NEBU

Facility

$2.14

Service Code	HCPCS J7614
Hospital Charge Code	3557344425
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07

LEVALBUTEROL HCL 1.25 MG/3ML IN NEBU

Facility

$0.67

Service Code	HCPCS J7614
Hospital Charge Code	7620490001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33

LEVALBUTEROL HCL 1.25 MG/3ML IN NEBU

Facility

$2.15

Service Code	HCPCS J7614
Hospital Charge Code	0115993278
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07

LEVALBUTEROL HCL 1.25 MG/3ML IN NEBU

Facility

$2.15

Service Code	HCPCS J7614
Hospital Charge Code	0115993278
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$1.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.46
Rate for Payer: EmblemHealth Commercial	$1.07
Rate for Payer: Group Health Inc Commercial	$1.07
Rate for Payer: Group Health Inc Medicare	$0.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07
Rate for Payer: Hamaspik Choice Inc Medicare	$1.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.39

LEVALBUTEROL HCL 1.25 MG/3ML IN NEBU

Facility

$0.67

Service Code	HCPCS J7614
Hospital Charge Code	7620490011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.45
Rate for Payer: EmblemHealth Commercial	$0.33
Rate for Payer: Group Health Inc Commercial	$0.33
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33
Rate for Payer: Hamaspik Choice Inc Medicare	$0.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.43

LEVALBUTEROL HCL 1.25 MG/3ML IN NEBU

Facility

$0.67

Service Code	HCPCS J7614
Hospital Charge Code	7620490011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33

LEVALBUTEROL HCL 1.25 MG/3ML IN NEBU

Facility

$0.67

Service Code	HCPCS J7614
Hospital Charge Code	7620490001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.45
Rate for Payer: EmblemHealth Commercial	$0.33
Rate for Payer: Group Health Inc Commercial	$0.33
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33
Rate for Payer: Hamaspik Choice Inc Medicare	$0.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.43

LEVALBUTEROL HCL 1.25 MG/3ML IN NEBU

Facility

$2.14

Service Code	HCPCS J7614
Hospital Charge Code	3557344525
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$1.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.46
Rate for Payer: EmblemHealth Commercial	$1.07
Rate for Payer: Group Health Inc Commercial	$1.07
Rate for Payer: Group Health Inc Medicare	$0.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07
Rate for Payer: Hamaspik Choice Inc Medicare	$1.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.39

LEVALBUTEROL HCL 1.25 MG/3ML IN NEBU

Facility

$2.14

Service Code	HCPCS J7614
Hospital Charge Code	3557344525
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07

LEVEL I ADJUNCTIVE GENERAL DENTAL SERVICES

Facility

$147.91

Service Code	EAPG 00350
Min. Negotiated Rate	$106.46
Max. Negotiated Rate	$147.91
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$106.46
Rate for Payer: Healthfirst Commercial	$147.91

LEVEL I ANAL AND RECTAL PROCEDURES

Facility

$1,896.31

Service Code	EAPG 00141
Min. Negotiated Rate	$1,377.01
Max. Negotiated Rate	$1,896.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,377.01
Rate for Payer: Healthfirst Commercial	$1,896.31

LEVEL I ANCILLARY THERAPEUTIC SERVICES

Facility

$32.40

Service Code	EAPG 00493
Min. Negotiated Rate	$32.40
Max. Negotiated Rate	$32.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32.40

LEVEL I ANTERIOR SEGMENT EYE PROCEDURES

Facility

$2,847.30

Service Code	EAPG 00234
Min. Negotiated Rate	$2,066.67
Max. Negotiated Rate	$2,847.30
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,066.67
Rate for Payer: Healthfirst Commercial	$2,847.30

LEVEL I ARTHROPLASTY

Facility

$5,290.65

Service Code	EAPG 00046
Min. Negotiated Rate	$3,839.42
Max. Negotiated Rate	$5,290.65
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,839.42
Rate for Payer: Healthfirst Commercial	$5,290.65

LEVEL I ARTHROSCOPY

Facility

$3,172.45

Service Code	EAPG 00037
Min. Negotiated Rate	$2,302.73
Max. Negotiated Rate	$3,172.45
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,302.73
Rate for Payer: Healthfirst Commercial	$3,172.45

LEVEL I BLADDER AND URETERAL PROCEDURES

Facility

$2,048.16

Service Code	EAPG 00173
Min. Negotiated Rate	$2,048.16
Max. Negotiated Rate	$2,048.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,048.16

LEVEL I BLOOD AND BLOOD PRODUCT EXCHANGE

Facility

$943.61

Service Code	EAPG 00113
Min. Negotiated Rate	$685.03
Max. Negotiated Rate	$943.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$685.03
Rate for Payer: Healthfirst Commercial	$943.61

LEVEL I BLOOD AND TISSUE TYPING TESTS

Facility

$81.84

Service Code	EAPG 00486
Min. Negotiated Rate	$60.17
Max. Negotiated Rate	$81.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.17
Rate for Payer: Healthfirst Commercial	$81.84

LEVEL I BLOOD PRODUCTS

Facility

$685.03

Service Code	EAPG 02061
Min. Negotiated Rate	$685.03
Max. Negotiated Rate	$685.03
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$685.03

LEVEL I BRACHYTHERAPY SOURCES

Facility

$1,245.09

Service Code	EAPG 00335
Min. Negotiated Rate	$1,245.09
Max. Negotiated Rate	$1,245.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,245.09

Know your out-of-pocket cost for care.

All Charges