St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MINOR DEVICE EVALUATION AND INTERROGATION

Facility

$144.87

Service Code	EAPG 00488
Min. Negotiated Rate	$104.14
Max. Negotiated Rate	$144.87
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$104.14
Rate for Payer: Healthfirst Commercial	$144.87

MINOR EAR, NOSE, MOUTH AND THROAT PROCEDURES

Facility

$168.94

Service Code	EAPG 00249
Min. Negotiated Rate	$168.94
Max. Negotiated Rate	$168.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$168.94

MINOR FEMALE REPRODUCTIVE PROCEDURES

Facility

$256.35

Service Code	EAPG 00417
Min. Negotiated Rate	$185.14
Max. Negotiated Rate	$256.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$185.14
Rate for Payer: Healthfirst Commercial	$256.35

MINOR MUSCULOSKELETAL PROCEDURES

Facility

$597.09

Service Code	EAPG 02030
Min. Negotiated Rate	$597.09
Max. Negotiated Rate	$597.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$597.09

MINOR OPHTHALMOLOGICAL INJECTION, SCRAPING AND TESTS

Facility

$157.88

Service Code	EAPG 00419
Min. Negotiated Rate	$115.72
Max. Negotiated Rate	$157.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$115.72
Rate for Payer: Healthfirst Commercial	$157.88

MINOR PULMONARY TESTS AND SERVICES

Facility

$128.64

Service Code	EAPG 00412
Min. Negotiated Rate	$92.57
Max. Negotiated Rate	$128.64
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$92.57
Rate for Payer: Healthfirst Commercial	$128.64

MINOR SPECIMEN COLLECTION SERVICES

Facility

$50.91

Service Code	EAPG 00304
Min. Negotiated Rate	$50.91
Max. Negotiated Rate	$50.91
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$50.91

MINOR SPLINT AND STRAPPING APPLICATION

Facility

$368.92

Service Code	EAPG 00040
Min. Negotiated Rate	$268.46
Max. Negotiated Rate	$368.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$268.46
Rate for Payer: Healthfirst Commercial	$368.92

MINOR UROLOGY SERVICES

Facility

$495.26

Service Code	EAPG 00159
Min. Negotiated Rate	$495.26
Max. Negotiated Rate	$495.26
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$495.26

MINOXIDIL 10 MG PO TABS

Facility

$2.12

Service Code	NDC 6808420511
Hospital Charge Code	6808420511
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06

MINOXIDIL 10 MG PO TABS

Facility

$2.12

Service Code	NDC 6808420501
Hospital Charge Code	6808420501
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06

MINOXIDIL 10 MG PO TABS

Facility

$2.12

Service Code	NDC 6808420501
Hospital Charge Code	6808420501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.06
Rate for Payer: Aetna Government	$1.06
Rate for Payer: Brighton Health Commercial	$1.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.44
Rate for Payer: EmblemHealth Commercial	$1.06
Rate for Payer: Group Health Inc Commercial	$1.06
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.38

MINOXIDIL 10 MG PO TABS

Facility

$2.12

Service Code	NDC 6808420511
Hospital Charge Code	6808420511
Hospital Revenue Code	250
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.06
Rate for Payer: Aetna Government	$1.06
Rate for Payer: Brighton Health Commercial	$1.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.44
Rate for Payer: EmblemHealth Commercial	$1.06
Rate for Payer: Group Health Inc Commercial	$1.06
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.38

MINOXIDIL 2.5 MG PO TABS

Facility

$0.78

Service Code	NDC 4988425601
Hospital Charge Code	4988425601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.39
Rate for Payer: Aetna Government	$0.39
Rate for Payer: Brighton Health Commercial	$0.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.53
Rate for Payer: EmblemHealth Commercial	$0.39
Rate for Payer: Group Health Inc Commercial	$0.39
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39
Rate for Payer: Hamaspik Choice Inc Medicare	$0.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.51

MINOXIDIL 2.5 MG PO TABS

Facility

$1.70

Service Code	NDC 6808420401
Hospital Charge Code	6808420401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.85

MINOXIDIL 2.5 MG PO TABS

Facility

$0.78

Service Code	NDC 4988425601
Hospital Charge Code	4988425601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39

MINOXIDIL 2.5 MG PO TABS

Facility

$1.70

Service Code	NDC 6808420401
Hospital Charge Code	6808420401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$1.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.85
Rate for Payer: Aetna Government	$0.85
Rate for Payer: Brighton Health Commercial	$1.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: EmblemHealth Commercial	$0.85
Rate for Payer: Group Health Inc Commercial	$0.85
Rate for Payer: Group Health Inc Medicare	$0.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.85
Rate for Payer: Hamaspik Choice Inc Medicare	$0.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.10

MINOXIDIL 2.5 MG PO TABS

Facility

$1.70

Service Code	NDC 6808420411
Hospital Charge Code	6808420411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.85

MINOXIDIL 2.5 MG PO TABS

Facility

$1.70

Service Code	NDC 6808420411
Hospital Charge Code	6808420411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$1.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.85
Rate for Payer: Aetna Government	$0.85
Rate for Payer: Brighton Health Commercial	$1.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: EmblemHealth Commercial	$0.85
Rate for Payer: Group Health Inc Commercial	$0.85
Rate for Payer: Group Health Inc Medicare	$0.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.85
Rate for Payer: Hamaspik Choice Inc Medicare	$0.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.10

MIRTAZAPINE 15 MG PO TABS

Facility

$2.72

Service Code	NDC 6050502471
Hospital Charge Code	6050502471
Hospital Revenue Code	250
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$1.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.36

MIRTAZAPINE 15 MG PO TABS

Facility

$2.72

Service Code	NDC 5766449983
Hospital Charge Code	5766449983
Hospital Revenue Code	250
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$1.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.36

MIRTAZAPINE 15 MG PO TABS

Facility

$2.72

Service Code	NDC 5766449983
Hospital Charge Code	5766449983
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$2.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.36
Rate for Payer: Aetna Government	$1.36
Rate for Payer: Brighton Health Commercial	$2.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.85
Rate for Payer: EmblemHealth Commercial	$1.36
Rate for Payer: Group Health Inc Commercial	$1.36
Rate for Payer: Group Health Inc Medicare	$0.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.36
Rate for Payer: Hamaspik Choice Inc Medicare	$1.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.76

MIRTAZAPINE 15 MG PO TABS

Facility

$2.70

Service Code	NDC 5723700805
Hospital Charge Code	5723700805
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.35

MIRTAZAPINE 15 MG PO TABS

Facility

$2.70

Service Code	NDC 5723700805
Hospital Charge Code	5723700805
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$2.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.35
Rate for Payer: Aetna Government	$1.35
Rate for Payer: Brighton Health Commercial	$2.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.84
Rate for Payer: EmblemHealth Commercial	$1.35
Rate for Payer: Group Health Inc Commercial	$1.35
Rate for Payer: Group Health Inc Medicare	$0.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.35
Rate for Payer: Hamaspik Choice Inc Medicare	$1.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.75

MIRTAZAPINE 15 MG PO TABS

Facility

$2.86

Service Code	NDC 0904651961
Hospital Charge Code	0904651961
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$2.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.43
Rate for Payer: Aetna Government	$1.43
Rate for Payer: Brighton Health Commercial	$2.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.94
Rate for Payer: EmblemHealth Commercial	$1.43
Rate for Payer: Group Health Inc Commercial	$1.43
Rate for Payer: Group Health Inc Medicare	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.43
Rate for Payer: Hamaspik Choice Inc Medicare	$1.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.86

Know your out-of-pocket cost for care.

All Charges