St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

METHYLPREDNISOLONE SODIUM SUCC 40 MG IJ SOLR (WRAPPED) (PEDIATRIC)

Facility

$8.11

Service Code	HCPCS J2919
Hospital Charge Code	0009003906
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$6.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.21
Rate for Payer: Aetna Government	$0.21
Rate for Payer: Affinity Essential Plan 1&2	$0.15
Rate for Payer: Affinity Essential Plan 3&4	$0.15
Rate for Payer: Affinity Medicaid/CHP/HARP	$0.15
Rate for Payer: Brighton Health Commercial	$6.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$0.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.51
Rate for Payer: Elderplan Medicare Advantage	$0.21
Rate for Payer: EmblemHealth Commercial	$0.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.19
Rate for Payer: Fidelis Essential Plan Aliesa	$0.18
Rate for Payer: Fidelis Essential Plan QHP	$0.19
Rate for Payer: Fidelis Medicare Advantage	$0.21
Rate for Payer: Fidelis Qualified Health Plan	$0.19
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.21
Rate for Payer: Healthfirst Medicare Advantage	$0.18
Rate for Payer: Healthfirst QHP	$0.21
Rate for Payer: Humana Medicare	$0.21
Rate for Payer: Senior Whole Health Medicare Advantage	$0.21
Rate for Payer: United Healthcare Medicare Advantage	$0.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$0.20
Rate for Payer: Wellcare Medicare	$0.20

METHYLPREDNISOLONE SODIUM SUCC 40 MG IJ SOLR (WRAPPED) (PEDIATRIC)

Facility

$7.76

Service Code	HCPCS J2919
Hospital Charge Code	0009003928
Hospital Revenue Code	250
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$3.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.88

METHYLPREDNISOLONE SODIUM SUCC 40 MG IJ SOLR (WRAPPED) (PEDIATRIC)

Facility

$8.11

Service Code	HCPCS J2919
Hospital Charge Code	0009003906
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.05

METHYLPREDNISOLONE SODIUM SUCC 40 MG IJ SOLR (WRAPPED) (PEDIATRIC)

Facility

$8.11

Service Code	HCPCS J2919
Hospital Charge Code	0009003905
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.05

METHYLPREDNISOLONE SODIUM SUCC 500 MG IJ SOLR

Facility

$29.14

Service Code	HCPCS J2919
Hospital Charge Code	0009075801
Hospital Revenue Code	250
Min. Negotiated Rate	$14.57
Max. Negotiated Rate	$14.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.57

METHYLPREDNISOLONE SODIUM SUCC 500 MG IJ SOLR

Facility

$29.14

Service Code	HCPCS J2919
Hospital Charge Code	0009075801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$23.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.21
Rate for Payer: Aetna Government	$0.21
Rate for Payer: Affinity Essential Plan 1&2	$0.15
Rate for Payer: Affinity Essential Plan 3&4	$0.15
Rate for Payer: Affinity Medicaid/CHP/HARP	$0.15
Rate for Payer: Brighton Health Commercial	$21.86
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$0.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.82
Rate for Payer: Elderplan Medicare Advantage	$0.21
Rate for Payer: EmblemHealth Commercial	$0.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.19
Rate for Payer: Fidelis Essential Plan Aliesa	$0.18
Rate for Payer: Fidelis Essential Plan QHP	$0.19
Rate for Payer: Fidelis Medicare Advantage	$0.21
Rate for Payer: Fidelis Qualified Health Plan	$0.19
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.21
Rate for Payer: Healthfirst Medicare Advantage	$0.18
Rate for Payer: Healthfirst QHP	$0.21
Rate for Payer: Humana Medicare	$0.21
Rate for Payer: Senior Whole Health Medicare Advantage	$0.21
Rate for Payer: United Healthcare Medicare Advantage	$0.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$0.20
Rate for Payer: Wellcare Medicare	$0.20

METOCLOPRAMIDE HCL 10 MG PO TABS

Facility

$0.72

Service Code	NDC 6068763101
Hospital Charge Code	6068763101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36

METOCLOPRAMIDE HCL 10 MG PO TABS

Facility

$0.28

Service Code	NDC 0093220301
Hospital Charge Code	0093220301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14

METOCLOPRAMIDE HCL 10 MG PO TABS

Facility

$0.72

Service Code	NDC 6068763111
Hospital Charge Code	6068763111
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36

METOCLOPRAMIDE HCL 10 MG PO TABS

Facility

$0.28

Service Code	NDC 0093220301
Hospital Charge Code	0093220301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Brighton Health Commercial	$0.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.19
Rate for Payer: EmblemHealth Commercial	$0.14
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

METOCLOPRAMIDE HCL 10 MG PO TABS

Facility

$0.72

Service Code	NDC 6068763101
Hospital Charge Code	6068763101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.36
Rate for Payer: Aetna Government	$0.36
Rate for Payer: Brighton Health Commercial	$0.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.49
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	$0.47

METOCLOPRAMIDE HCL 10 MG PO TABS

Facility

$0.72

Service Code	NDC 6068763111
Hospital Charge Code	6068763111
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.36
Rate for Payer: Aetna Government	$0.36
Rate for Payer: Brighton Health Commercial	$0.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.49
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	$0.47

METOCLOPRAMIDE HCL 5 MG/5ML PO SOLN

Facility

$0.49

Service Code	NDC 0121157610
Hospital Charge Code	0121157610
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24

METOCLOPRAMIDE HCL 5 MG/5ML PO SOLN

Facility

$0.49

Service Code	NDC 0121157610
Hospital Charge Code	0121157610
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.24
Rate for Payer: Aetna Government	$0.24
Rate for Payer: Brighton Health Commercial	$0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.33
Rate for Payer: EmblemHealth Commercial	$0.24
Rate for Payer: Group Health Inc Commercial	$0.24
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24
Rate for Payer: Hamaspik Choice Inc Medicare	$0.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.32

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$2.01

Service Code	HCPCS J2765
Hospital Charge Code	0703450204
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
Rate for Payer: Brighton Health Commercial	$1.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.37
Rate for Payer: EmblemHealth Commercial	$1.01
Rate for Payer: Group Health Inc Commercial	$1.01
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01
Rate for Payer: Hamaspik Choice Inc Medicare	$1.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.31

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$1.32

Service Code	HCPCS J2765
Hospital Charge Code	2315524041
Hospital Revenue Code	250
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.66

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$0.75

Service Code	HCPCS J2765
Hospital Charge Code	0409341401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
Rate for Payer: Brighton Health Commercial	$0.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.51
Rate for Payer: EmblemHealth Commercial	$0.37
Rate for Payer: Group Health Inc Commercial	$0.37
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37
Rate for Payer: Hamaspik Choice Inc Medicare	$0.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.48

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$2.01

Service Code	HCPCS J2765
Hospital Charge Code	0703450204
Hospital Revenue Code	250
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$0.75

Service Code	HCPCS J2765
Hospital Charge Code	0409341421
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$1.32

Service Code	HCPCS J2765
Hospital Charge Code	2315524041
Hospital Revenue Code	250
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$1.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
Rate for Payer: Brighton Health Commercial	$0.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.90
Rate for Payer: EmblemHealth Commercial	$0.66
Rate for Payer: Group Health Inc Commercial	$0.66
Rate for Payer: Group Health Inc Medicare	$0.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.66
Rate for Payer: Hamaspik Choice Inc Medicare	$0.66
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.86

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$0.75

Service Code	HCPCS J2765
Hospital Charge Code	0409341421
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
Rate for Payer: Brighton Health Commercial	$0.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.51
Rate for Payer: EmblemHealth Commercial	$0.37
Rate for Payer: Group Health Inc Commercial	$0.37
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37
Rate for Payer: Hamaspik Choice Inc Medicare	$0.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.48

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$0.75

Service Code	HCPCS J2765
Hospital Charge Code	0409341401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$2.01

Service Code	HCPCS J2765
Hospital Charge Code	0703450201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
Rate for Payer: Brighton Health Commercial	$1.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.37
Rate for Payer: EmblemHealth Commercial	$1.01
Rate for Payer: Group Health Inc Commercial	$1.01
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01
Rate for Payer: Hamaspik Choice Inc Medicare	$1.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.31

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$1.95

Service Code	HCPCS J2765
Hospital Charge Code	7604521300
Hospital Revenue Code	250
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.98

METOCLOPRAMIDE HCL 5 MG/ML IJ SOLN

Facility

$2.01

Service Code	HCPCS J2765
Hospital Charge Code	0703450201
Hospital Revenue Code	250
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01

Know your out-of-pocket cost for care.

All Charges