St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MEROPENEM 500 MG IV SOLR

Facility

$7.20

Service Code	HCPCS J2185
Hospital Charge Code	5515020720
Hospital Revenue Code	258
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$5.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.79
Rate for Payer: Aetna Government	$0.79
Rate for Payer: Brighton Health Commercial	$5.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.90
Rate for Payer: EmblemHealth Commercial	$3.60
Rate for Payer: Group Health Inc Commercial	$3.60
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.68

MEROPENEM 500 MG IV SOLR

Facility

$7.20

Service Code	HCPCS J2185
Hospital Charge Code	5515020720
Hospital Revenue Code	258
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60

MEROPENEM 500 MG IV SOLR

Facility

$12.36

Service Code	HCPCS J2185
Hospital Charge Code	0409139021
Hospital Revenue Code	258
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$9.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.79
Rate for Payer: Aetna Government	$0.79
Rate for Payer: Brighton Health Commercial	$9.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.40
Rate for Payer: EmblemHealth Commercial	$6.18
Rate for Payer: Group Health Inc Commercial	$6.18
Rate for Payer: Group Health Inc Medicare	$4.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.18
Rate for Payer: Hamaspik Choice Inc Medicare	$6.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.03

MEROPENEM 500 MG IV SOLR

Facility

$18.21

Service Code	HCPCS J2185
Hospital Charge Code	0781300095
Hospital Revenue Code	258
Min. Negotiated Rate	$9.11
Max. Negotiated Rate	$9.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.11

MEROPENEM 500 MG IV SOLR

Facility

$7.20

Service Code	HCPCS J2185
Hospital Charge Code	7012114541
Hospital Revenue Code	258
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60

MEROPENEM 500 MG IV SOLR

Facility

$7.20

Service Code	HCPCS J2185
Hospital Charge Code	7012114547
Hospital Revenue Code	258
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60

MEROPENEM 500 MG IV SOLR

Facility

$12.36

Service Code	HCPCS J2185
Hospital Charge Code	0409139021
Hospital Revenue Code	258
Min. Negotiated Rate	$6.18
Max. Negotiated Rate	$6.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.18

MEROPENEM-VABORBACTAM 2 (1-1) G IV SOLR

Facility

$259.20

Service Code	HCPCS J3490
Hospital Charge Code	7084212006
Hospital Revenue Code	258
Min. Negotiated Rate	$129.60
Max. Negotiated Rate	$129.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$129.60

MEROPENEM-VABORBACTAM 2 (1-1) G IV SOLR

Facility

$259.20

Service Code	HCPCS J3490
Hospital Charge Code	7084212006
Hospital Revenue Code	258
Min. Negotiated Rate	$90.72
Max. Negotiated Rate	$207.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$142.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$129.60
Rate for Payer: Aetna Government	$129.60
Rate for Payer: Brighton Health Commercial	$194.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$207.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.26
Rate for Payer: EmblemHealth Commercial	$129.60
Rate for Payer: Group Health Inc Commercial	$129.60
Rate for Payer: Group Health Inc Medicare	$90.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$129.60
Rate for Payer: Hamaspik Choice Inc Medicare	$129.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$168.48

MESALAMINE 4 G RE ENEM

Facility

$0.39

Service Code	NDC 4580209828
Hospital Charge Code	4580209828
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.19
Rate for Payer: Aetna Government	$0.19
Rate for Payer: Brighton Health Commercial	$0.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.26
Rate for Payer: EmblemHealth Commercial	$0.19
Rate for Payer: Group Health Inc Commercial	$0.19
Rate for Payer: Group Health Inc Medicare	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19
Rate for Payer: Hamaspik Choice Inc Medicare	$0.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.25

MESALAMINE 4 G RE ENEM

Facility

$0.39

Service Code	NDC 4580209828
Hospital Charge Code	4580209828
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19

MESALAMINE 4 G RE ENEM

Facility

$0.41

Service Code	NDC 4580209851
Hospital Charge Code	4580209851
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20

MESALAMINE 4 G RE ENEM

Facility

$0.41

Service Code	NDC 4580209851
Hospital Charge Code	4580209851
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.20
Rate for Payer: Aetna Government	$0.20
Rate for Payer: Brighton Health Commercial	$0.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.28
Rate for Payer: EmblemHealth Commercial	$0.20
Rate for Payer: Group Health Inc Commercial	$0.20
Rate for Payer: Group Health Inc Medicare	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.20
Rate for Payer: Hamaspik Choice Inc Medicare	$0.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.26

MESALAMINE 800 MG PO TBEC

Facility

$9.27

Service Code	NDC 6838243528
Hospital Charge Code	6838243528
Hospital Revenue Code	250
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$7.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.64
Rate for Payer: Aetna Government	$4.64
Rate for Payer: Brighton Health Commercial	$6.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.31
Rate for Payer: EmblemHealth Commercial	$4.64
Rate for Payer: Group Health Inc Commercial	$4.64
Rate for Payer: Group Health Inc Medicare	$3.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.64
Rate for Payer: Hamaspik Choice Inc Medicare	$4.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.03

MESALAMINE 800 MG PO TBEC

Facility

$9.27

Service Code	NDC 6838243528
Hospital Charge Code	6838243528
Hospital Revenue Code	250
Min. Negotiated Rate	$4.64
Max. Negotiated Rate	$4.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.64

MESNA 100 MG/ML IV SOLN

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	1001995301
Hospital Revenue Code	258
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50

MESNA 100 MG/ML IV SOLN

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	1001995301
Hospital Revenue Code	258
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.11
Rate for Payer: Aetna Government	$2.11
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: EmblemHealth Commercial	$1.50
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

MESNA 100 MG/ML IV SOLN

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	0338130501
Hospital Revenue Code	258
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.11
Rate for Payer: Aetna Government	$2.11
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: EmblemHealth Commercial	$1.50
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

MESNA 100 MG/ML IV SOLN

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	0338130501
Hospital Revenue Code	258
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50

METFORMIN HCL 500 MG PO TABS

Facility

$0.08

Service Code	NDC 0904716261
Hospital Charge Code	0904716261
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: EmblemHealth Commercial	$0.04
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

METFORMIN HCL 500 MG PO TABS

Facility

$0.71

Service Code	NDC 6586200801
Hospital Charge Code	6586200801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.36
Rate for Payer: Aetna Government	$0.36
Rate for Payer: Brighton Health Commercial	$0.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.48
Rate for Payer: EmblemHealth Commercial	$0.36
Rate for Payer: Group Health Inc Commercial	$0.36
Rate for Payer: Group Health Inc Medicare	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36
Rate for Payer: Hamaspik Choice Inc Medicare	$0.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.46

METFORMIN HCL 500 MG PO TABS

Facility

$0.71

Service Code	NDC 6586200801
Hospital Charge Code	6586200801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36

METFORMIN HCL 500 MG PO TABS

Facility

$0.08

Service Code	NDC 0904716261
Hospital Charge Code	0904716261
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04

METFORMIN HCL 500 MG PO TABS

Facility

$0.04

Service Code	NDC 2315510205
Hospital Charge Code	2315510205
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

METFORMIN HCL 500 MG PO TABS

Facility

$0.03

Service Code	NDC 2315510210
Hospital Charge Code	2315510210
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

Know your out-of-pocket cost for care.

All Charges