St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MORPHINE SULFATE (PF) 2 MG/ML IV SOLN

Facility

$5.19

Service Code	HCPCS J2270
Hospital Charge Code	0641619101
Hospital Revenue Code	258
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$4.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.39
Rate for Payer: Aetna Government	$3.39
Rate for Payer: Brighton Health Commercial	$3.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.53
Rate for Payer: EmblemHealth Commercial	$2.59
Rate for Payer: Group Health Inc Commercial	$2.59
Rate for Payer: Group Health Inc Medicare	$1.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.59
Rate for Payer: Hamaspik Choice Inc Medicare	$2.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.37

MORPHINE SULFATE (PF) 2 MG/ML IV SOLN

Facility

$2.56

Service Code	HCPCS J2270
Hospital Charge Code	0409189001
Hospital Revenue Code	258
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$3.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.39
Rate for Payer: Aetna Government	$3.39
Rate for Payer: Brighton Health Commercial	$1.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.74
Rate for Payer: EmblemHealth Commercial	$1.28
Rate for Payer: Group Health Inc Commercial	$1.28
Rate for Payer: Group Health Inc Medicare	$0.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.28
Rate for Payer: Hamaspik Choice Inc Medicare	$1.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.66

MORPHINE SULFATE (PF) 2 MG/ML IV SOLN

Facility

$2.56

Service Code	HCPCS J2270
Hospital Charge Code	0409189001
Hospital Revenue Code	258
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$1.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.28

MORPHINE SULFATE (PF) 2 MG/ML IV SOLN

Facility

$5.15

Service Code	HCPCS J2270
Hospital Charge Code	0409189013
Hospital Revenue Code	258
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$4.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.39
Rate for Payer: Aetna Government	$3.39
Rate for Payer: Brighton Health Commercial	$3.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.50
Rate for Payer: EmblemHealth Commercial	$2.58
Rate for Payer: Group Health Inc Commercial	$2.58
Rate for Payer: Group Health Inc Medicare	$1.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.58
Rate for Payer: Hamaspik Choice Inc Medicare	$2.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.35

MORPHINE SULFATE (PF) 2 MG/ML IV SOLN

Facility

$5.14

Service Code	HCPCS J2270
Hospital Charge Code	0409189023
Hospital Revenue Code	258
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$4.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.39
Rate for Payer: Aetna Government	$3.39
Rate for Payer: Brighton Health Commercial	$3.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.50
Rate for Payer: EmblemHealth Commercial	$2.57
Rate for Payer: Group Health Inc Commercial	$2.57
Rate for Payer: Group Health Inc Medicare	$1.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.57
Rate for Payer: Hamaspik Choice Inc Medicare	$2.57
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.34

MORPHINE SULFATE (PF) 2 MG/ML IV SOLN

Facility

$5.19

Service Code	HCPCS J2270
Hospital Charge Code	0641619110
Hospital Revenue Code	258
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$4.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.39
Rate for Payer: Aetna Government	$3.39
Rate for Payer: Brighton Health Commercial	$3.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.53
Rate for Payer: EmblemHealth Commercial	$2.59
Rate for Payer: Group Health Inc Commercial	$2.59
Rate for Payer: Group Health Inc Medicare	$1.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.59
Rate for Payer: Hamaspik Choice Inc Medicare	$2.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.37

MORPHINE SULFATE (PF) 2 MG/ML IV SOLN

Facility

$5.15

Service Code	HCPCS J2270
Hospital Charge Code	0409189013
Hospital Revenue Code	258
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$2.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.58

MORPHINE SULFATE (PF) 2 MG/ML IV SOLN

Facility

$5.19

Service Code	HCPCS J2270
Hospital Charge Code	0641619101
Hospital Revenue Code	258
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$2.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.59

MORPHINE SULFATE (PF) 4 MG/ML IJ SOLN

Facility

$3.44

Service Code	HCPCS J2270
Hospital Charge Code	6332345401
Hospital Revenue Code	250
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$3.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.39
Rate for Payer: Aetna Government	$3.39
Rate for Payer: Brighton Health Commercial	$2.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.34
Rate for Payer: EmblemHealth Commercial	$1.72
Rate for Payer: Group Health Inc Commercial	$1.72
Rate for Payer: Group Health Inc Medicare	$1.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.72
Rate for Payer: Hamaspik Choice Inc Medicare	$1.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.24

MORPHINE SULFATE (PF) 4 MG/ML IJ SOLN

Facility

$3.44

Service Code	HCPCS J2270
Hospital Charge Code	6332345400
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$3.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.39
Rate for Payer: Aetna Government	$3.39
Rate for Payer: Brighton Health Commercial	$2.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.34
Rate for Payer: EmblemHealth Commercial	$1.72
Rate for Payer: Group Health Inc Commercial	$1.72
Rate for Payer: Group Health Inc Medicare	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.72
Rate for Payer: Hamaspik Choice Inc Medicare	$1.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.24

MORPHINE SULFATE (PF) 4 MG/ML IJ SOLN

Facility

$3.44

Service Code	HCPCS J2270
Hospital Charge Code	6332345400
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$1.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.72

MORPHINE SULFATE (PF) 4 MG/ML IJ SOLN

Facility

$3.44

Service Code	HCPCS J2270
Hospital Charge Code	6332345401
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$1.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.72

MORPHINE SULFATE (PF) 4 MG/ML IV SOLN

Facility

$2.34

Service Code	HCPCS J2270
Hospital Charge Code	0409189101
Hospital Revenue Code	258
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$3.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.39
Rate for Payer: Aetna Government	$3.39
Rate for Payer: Brighton Health Commercial	$1.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.59
Rate for Payer: EmblemHealth Commercial	$1.17
Rate for Payer: Group Health Inc Commercial	$1.17
Rate for Payer: Group Health Inc Medicare	$0.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.17
Rate for Payer: Hamaspik Choice Inc Medicare	$1.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.52

MORPHINE SULFATE (PF) 4 MG/ML IV SOLN

Facility

$2.34

Service Code	HCPCS J2270
Hospital Charge Code	0409189101
Hospital Revenue Code	258
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.17

MORPHINE SULF MICROINFUSION PF 200 MG/20ML (10 MG/ML) IJ SOLN

Facility

$12.49

Service Code	HCPCS J2274
Hospital Charge Code	6679416002
Hospital Revenue Code	250
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$12.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$9.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.49
Rate for Payer: EmblemHealth Commercial	$6.25
Rate for Payer: Group Health Inc Commercial	$6.25
Rate for Payer: Group Health Inc Medicare	$4.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.25
Rate for Payer: Hamaspik Choice Inc Medicare	$6.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$12.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.12

MORPHINE SULF MICROINFUSION PF 200 MG/20ML (10 MG/ML) IJ SOLN

Facility

$12.49

Service Code	HCPCS J2274
Hospital Charge Code	6679416002
Hospital Revenue Code	250
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$6.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.25

MORPHINE SULF MICROINFUSION PF 500 MG/20ML (25 MG/ML) IJ SOLN

Facility

$21.24

Service Code	HCPCS J2274
Hospital Charge Code	6679416202
Hospital Revenue Code	250
Min. Negotiated Rate	$10.62
Max. Negotiated Rate	$10.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.62

MORPHINE SULF MICROINFUSION PF 500 MG/20ML (25 MG/ML) IJ SOLN

Facility

$21.24

Service Code	HCPCS J2274
Hospital Charge Code	6679416202
Hospital Revenue Code	250
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$16.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$15.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.44
Rate for Payer: EmblemHealth Commercial	$10.62
Rate for Payer: Group Health Inc Commercial	$10.62
Rate for Payer: Group Health Inc Medicare	$7.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.62
Rate for Payer: Hamaspik Choice Inc Medicare	$10.62
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$12.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.80

MOXIFLOXACIN HCL 0.5 % OP SOLN

Facility

$4.64

Service Code	NDC 7226615801
Hospital Charge Code	7226615801
Hospital Revenue Code	250
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$2.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.32

MOXIFLOXACIN HCL 0.5 % OP SOLN

Facility

$4.64

Service Code	NDC 7226615801
Hospital Charge Code	7226615801
Hospital Revenue Code	250
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$3.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.32
Rate for Payer: Aetna Government	$2.32
Rate for Payer: Brighton Health Commercial	$3.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.16
Rate for Payer: EmblemHealth Commercial	$2.32
Rate for Payer: Group Health Inc Commercial	$2.32
Rate for Payer: Group Health Inc Medicare	$1.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.32
Rate for Payer: Hamaspik Choice Inc Medicare	$2.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.02

MOXIFLOXACIN HCL 0.5 % OP SOLN

Facility

$55.78

Service Code	NDC 6050505824
Hospital Charge Code	6050505824
Hospital Revenue Code	250
Min. Negotiated Rate	$19.52
Max. Negotiated Rate	$44.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.89
Rate for Payer: Aetna Government	$27.89
Rate for Payer: Brighton Health Commercial	$41.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.93
Rate for Payer: EmblemHealth Commercial	$27.89
Rate for Payer: Group Health Inc Commercial	$27.89
Rate for Payer: Group Health Inc Medicare	$19.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.89
Rate for Payer: Hamaspik Choice Inc Medicare	$27.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.26

MOXIFLOXACIN HCL 0.5 % OP SOLN

Facility

$55.78

Service Code	NDC 6050505824
Hospital Charge Code	6050505824
Hospital Revenue Code	250
Min. Negotiated Rate	$27.89
Max. Negotiated Rate	$27.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.89

MOXIFLOXACIN HCL 400 MG/250ML IV SOLN

Facility

$0.22

Service Code	HCPCS J2280
Hospital Charge Code	6332385074
Hospital Revenue Code	258
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$9.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.22
Rate for Payer: Aetna Government	$9.22
Rate for Payer: Brighton Health Commercial	$0.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.15
Rate for Payer: EmblemHealth Commercial	$0.11
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11
Rate for Payer: Hamaspik Choice Inc Medicare	$0.11
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.14

MOXIFLOXACIN HCL 400 MG/250ML IV SOLN

Facility

$0.22

Service Code	HCPCS J2280
Hospital Charge Code	6332385074
Hospital Revenue Code	258
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

MOXIFLOXACIN HCL 400 MG PO TABS

Facility

$27.23

Service Code	NDC 6586260330
Hospital Charge Code	6586260330
Hospital Revenue Code	250
Min. Negotiated Rate	$9.53
Max. Negotiated Rate	$21.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.61
Rate for Payer: Aetna Government	$13.61
Rate for Payer: Brighton Health Commercial	$20.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.51
Rate for Payer: EmblemHealth Commercial	$13.61
Rate for Payer: Group Health Inc Commercial	$13.61
Rate for Payer: Group Health Inc Medicare	$9.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.61
Rate for Payer: Hamaspik Choice Inc Medicare	$13.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.70

Know your out-of-pocket cost for care.

All Charges