St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CARVEDILOL 25 MG PO TABS

Facility

$2.14

Service Code	NDC 6838209501
Hospital Charge Code	6838209501
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07

CARVEDILOL 25 MG PO TABS

Facility

$0.11

Service Code	NDC 0904730861
Hospital Charge Code	0904730861
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.05
Rate for Payer: Aetna Government	$0.05
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: EmblemHealth Commercial	$0.05
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

CARVEDILOL 25 MG PO TABS

Facility

$0.11

Service Code	NDC 0904730861
Hospital Charge Code	0904730861
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05

CARVEDILOL 3.125 MG PO TABS

Facility

$2.14

Service Code	NDC 0093005101
Hospital Charge Code	0093005101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.07
Rate for Payer: Aetna Government	$1.07
Rate for Payer: Brighton Health Commercial	$1.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.45
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.39

CARVEDILOL 3.125 MG PO TABS

Facility

$2.14

Service Code	NDC 6838209201
Hospital Charge Code	6838209201
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07

CARVEDILOL 3.125 MG PO TABS

Facility

$2.14

Service Code	NDC 6838209201
Hospital Charge Code	6838209201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.07
Rate for Payer: Aetna Government	$1.07
Rate for Payer: Brighton Health Commercial	$1.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.45
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.39

CARVEDILOL 3.125 MG PO TABS

Facility

$2.14

Service Code	NDC 7638511050
Hospital Charge Code	7638511050
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.07
Rate for Payer: Aetna Government	$1.07
Rate for Payer: Brighton Health Commercial	$1.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.45
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.39

CARVEDILOL 3.125 MG PO TABS

Facility

$2.10

Service Code	NDC 6846216205
Hospital Charge Code	6846216205
Hospital Revenue Code	250
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.05
Rate for Payer: Aetna Government	$1.05
Rate for Payer: Brighton Health Commercial	$1.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.43
Rate for Payer: EmblemHealth Commercial	$1.05
Rate for Payer: Group Health Inc Commercial	$1.05
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.37

CARVEDILOL 3.125 MG PO TABS

Facility

$0.11

Service Code	NDC 0904730561
Hospital Charge Code	0904730561
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05

CARVEDILOL 3.125 MG PO TABS

Facility

$2.10

Service Code	NDC 6846216205
Hospital Charge Code	6846216205
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05

CARVEDILOL 3.125 MG PO TABS

Facility

$2.14

Service Code	NDC 7638511050
Hospital Charge Code	7638511050
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07

CARVEDILOL 3.125 MG PO TABS

Facility

$2.10

Service Code	NDC 6846216201
Hospital Charge Code	6846216201
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05

CARVEDILOL 3.125 MG PO TABS

Facility

$2.14

Service Code	NDC 0093005101
Hospital Charge Code	0093005101
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07

CARVEDILOL 3.125 MG PO TABS

Facility

$0.11

Service Code	NDC 0904730561
Hospital Charge Code	0904730561
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.05
Rate for Payer: Aetna Government	$0.05
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: EmblemHealth Commercial	$0.05
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

CARVEDILOL 3.125 MG PO TABS

Facility

$2.10

Service Code	NDC 6846216201
Hospital Charge Code	6846216201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.05
Rate for Payer: Aetna Government	$1.05
Rate for Payer: Brighton Health Commercial	$1.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.43
Rate for Payer: EmblemHealth Commercial	$1.05
Rate for Payer: Group Health Inc Commercial	$1.05
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.37

CARVEDILOL 6.25 MG PO TABS

Facility

$0.75

Service Code	NDC 0904730661
Hospital Charge Code	0904730661
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.38
Rate for Payer: Aetna Government	$0.38
Rate for Payer: Brighton Health Commercial	$0.57
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	$0.38
Rate for Payer: Group Health Inc Commercial	$0.38
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.38
Rate for Payer: Hamaspik Choice Inc Medicare	$0.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.49

CARVEDILOL 6.25 MG PO TABS

Facility

$2.10

Service Code	NDC 6846216301
Hospital Charge Code	6846216301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.05
Rate for Payer: Aetna Government	$1.05
Rate for Payer: Brighton Health Commercial	$1.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.43
Rate for Payer: EmblemHealth Commercial	$1.05
Rate for Payer: Group Health Inc Commercial	$1.05
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.37

CARVEDILOL 6.25 MG PO TABS

Facility

$2.14

Service Code	NDC 0781522201
Hospital Charge Code	0781522201
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.07

CARVEDILOL 6.25 MG PO TABS

Facility

$2.14

Service Code	NDC 0781522201
Hospital Charge Code	0781522201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.07
Rate for Payer: Aetna Government	$1.07
Rate for Payer: Brighton Health Commercial	$1.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.45
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.39

CARVEDILOL 6.25 MG PO TABS

Facility

$2.10

Service Code	NDC 6846216301
Hospital Charge Code	6846216301
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05

CARVEDILOL 6.25 MG PO TABS

Facility

$0.75

Service Code	NDC 0904730661
Hospital Charge Code	0904730661
Hospital Revenue Code	250
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.38

CARVEDILOL 6.25 MG PO TABS

Facility

$2.10

Service Code	NDC 6846216305
Hospital Charge Code	6846216305
Hospital Revenue Code	250
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.05
Rate for Payer: Aetna Government	$1.05
Rate for Payer: Brighton Health Commercial	$1.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.43
Rate for Payer: EmblemHealth Commercial	$1.05
Rate for Payer: Group Health Inc Commercial	$1.05
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.37

CARVEDILOL 6.25 MG PO TABS

Facility

$2.10

Service Code	NDC 6846216305
Hospital Charge Code	6846216305
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05

CAST APPLICATION OR REPLACEMENT

Facility

$504.21

Service Code	EAPG 00039
Min. Negotiated Rate	$365.66
Max. Negotiated Rate	$504.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$365.66
Rate for Payer: Healthfirst Commercial	$504.21

CATARACT PROCEDURES

Facility

$3,545.72

Service Code	EAPG 00233
Min. Negotiated Rate	$2,573.50
Max. Negotiated Rate	$3,545.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,573.50
Rate for Payer: Healthfirst Commercial	$3,545.72

Know your out-of-pocket cost for care.

All Charges