St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

LIDOCAINE HCL (PF) 1 % IJ SOLN

Facility

$0.94

Service Code	NDC 6332349257
Hospital Charge Code	6332349257
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.47
Rate for Payer: Aetna Government	$0.47
Rate for Payer: Brighton Health Commercial	$0.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.64
Rate for Payer: EmblemHealth Commercial	$0.47
Rate for Payer: Group Health Inc Commercial	$0.47
Rate for Payer: Group Health Inc Medicare	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.47
Rate for Payer: Hamaspik Choice Inc Medicare	$0.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.61

LIDOCAINE HCL (PF) 1 % IJ SOLN

Facility

$0.59

Service Code	NDC 7329300011
Hospital Charge Code	7329300011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30

LIDOCAINE HCL (PF) 1 % IJ SOLN

Facility

$0.94

Service Code	NDC 6332349257
Hospital Charge Code	6332349257
Hospital Revenue Code	250
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.47

LIDOCAINE HCL (PF) 1 % IJ SOLN

Facility

$0.59

Service Code	NDC 7329300011
Hospital Charge Code	7329300011
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.40
Rate for Payer: EmblemHealth Commercial	$0.30
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.38

LIDOCAINE HCL (PF) 1 % IJ SOLN

Facility

$0.47

Service Code	NDC 6332349237
Hospital Charge Code	6332349237
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24

LIDOCAINE HCL (PF) 1 % IJ SOLN

Facility

$0.81

Service Code	NDC 5515016205
Hospital Charge Code	5515016205
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.41
Rate for Payer: Aetna Government	$0.41
Rate for Payer: Brighton Health Commercial	$0.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.55
Rate for Payer: EmblemHealth Commercial	$0.41
Rate for Payer: Group Health Inc Commercial	$0.41
Rate for Payer: Group Health Inc Medicare	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.41
Rate for Payer: Hamaspik Choice Inc Medicare	$0.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.53

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.51

Service Code	NDC 0409428202
Hospital Charge Code	0409428202
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.86

Service Code	NDC 6332349507
Hospital Charge Code	6332349507
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$1.76

Service Code	NDC 6332349509
Hospital Charge Code	6332349509
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$1.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.88
Rate for Payer: Aetna Government	$0.88
Rate for Payer: Brighton Health Commercial	$1.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.20
Rate for Payer: EmblemHealth Commercial	$0.88
Rate for Payer: Group Health Inc Commercial	$0.88
Rate for Payer: Group Health Inc Medicare	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.88
Rate for Payer: Hamaspik Choice Inc Medicare	$0.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.14

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.51

Service Code	NDC 0409428212
Hospital Charge Code	0409428212
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.86

Service Code	NDC 6332349504
Hospital Charge Code	6332349504
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$1.76

Service Code	NDC 6332349527
Hospital Charge Code	6332349527
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$1.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.88
Rate for Payer: Aetna Government	$0.88
Rate for Payer: Brighton Health Commercial	$1.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.20
Rate for Payer: EmblemHealth Commercial	$0.88
Rate for Payer: Group Health Inc Commercial	$0.88
Rate for Payer: Group Health Inc Medicare	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.88
Rate for Payer: Hamaspik Choice Inc Medicare	$0.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.14

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.51

Service Code	NDC 0409428212
Hospital Charge Code	0409428212
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.26
Rate for Payer: Aetna Government	$0.26
Rate for Payer: Brighton Health Commercial	$0.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.35
Rate for Payer: EmblemHealth Commercial	$0.26
Rate for Payer: Group Health Inc Commercial	$0.26
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26
Rate for Payer: Hamaspik Choice Inc Medicare	$0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.33

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.72

Service Code	NDC 5515016505
Hospital Charge Code	5515016505
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$1.76

Service Code	NDC 6332349509
Hospital Charge Code	6332349509
Hospital Revenue Code	250
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.88

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$2.25

Service Code	NDC 5515016402
Hospital Charge Code	5515016402
Hospital Revenue Code	250
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$2.25

Service Code	NDC 5515016402
Hospital Charge Code	5515016402
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$1.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.12
Rate for Payer: Aetna Government	$1.12
Rate for Payer: Brighton Health Commercial	$1.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.53
Rate for Payer: EmblemHealth Commercial	$1.12
Rate for Payer: Group Health Inc Commercial	$1.12
Rate for Payer: Group Health Inc Medicare	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.46

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.86

Service Code	NDC 6332349504
Hospital Charge Code	6332349504
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.43
Rate for Payer: Aetna Government	$0.43
Rate for Payer: Brighton Health Commercial	$0.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.59
Rate for Payer: EmblemHealth Commercial	$0.43
Rate for Payer: Group Health Inc Commercial	$0.43
Rate for Payer: Group Health Inc Medicare	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43
Rate for Payer: Hamaspik Choice Inc Medicare	$0.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.56

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.51

Service Code	NDC 0409428202
Hospital Charge Code	0409428202
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.26
Rate for Payer: Aetna Government	$0.26
Rate for Payer: Brighton Health Commercial	$0.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.35
Rate for Payer: EmblemHealth Commercial	$0.26
Rate for Payer: Group Health Inc Commercial	$0.26
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26
Rate for Payer: Hamaspik Choice Inc Medicare	$0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.33

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.83

Service Code	NDC 6332349697
Hospital Charge Code	6332349697
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$1.76

Service Code	NDC 6332349527
Hospital Charge Code	6332349527
Hospital Revenue Code	250
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.88

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.83

Service Code	NDC 6332349697
Hospital Charge Code	6332349697
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Brighton Health Commercial	$0.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: EmblemHealth Commercial	$0.42
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.54

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$0.83

Service Code	NDC 6332349603
Hospital Charge Code	6332349603
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Brighton Health Commercial	$0.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: EmblemHealth Commercial	$0.42
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.54

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$1.13

Service Code	NDC 5515016072
Hospital Charge Code	5515016072
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.56
Rate for Payer: Aetna Government	$0.56
Rate for Payer: Brighton Health Commercial	$0.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.77
Rate for Payer: EmblemHealth Commercial	$0.56
Rate for Payer: Group Health Inc Commercial	$0.56
Rate for Payer: Group Health Inc Medicare	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56
Rate for Payer: Hamaspik Choice Inc Medicare	$0.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.73

LIDOCAINE HCL (PF) 2 % IJ SOLN

Facility

$1.13

Service Code	NDC 5515016072
Hospital Charge Code	5515016072
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56

Know your out-of-pocket cost for care.

All Charges