St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CATARACTS

Facility

$217.85

Service Code	EAPG 00551
Min. Negotiated Rate	$157.37
Max. Negotiated Rate	$217.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$157.37
Rate for Payer: Healthfirst Commercial	$217.85

CEFAZOLIN IV SYRINGE 20 MG/ML IN D5W (NEO/PED)

Facility

$3.28

Service Code	NDC 9999123460
Hospital Charge Code	9999123460
Hospital Revenue Code	258
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.64

CEFAZOLIN IV SYRINGE 20 MG/ML IN D5W (NEO/PED)

Facility

$3.28

Service Code	NDC 9999123460
Hospital Charge Code	9999123460
Hospital Revenue Code	258
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$2.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.64
Rate for Payer: Aetna Government	$1.64
Rate for Payer: Brighton Health Commercial	$2.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.23
Rate for Payer: EmblemHealth Commercial	$1.64
Rate for Payer: Group Health Inc Commercial	$1.64
Rate for Payer: Group Health Inc Medicare	$1.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.64
Rate for Payer: Hamaspik Choice Inc Medicare	$1.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.13

CEFAZOLIN SODIUM 10 G IJ SOLR

Facility

$26.20

Service Code	HCPCS J0690
Hospital Charge Code	6050561430
Hospital Revenue Code	250
Min. Negotiated Rate	$13.10
Max. Negotiated Rate	$13.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.10

CEFAZOLIN SODIUM 10 G IJ SOLR

Facility

$26.20

Service Code	HCPCS J0690
Hospital Charge Code	6050561430
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$20.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$19.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.82
Rate for Payer: EmblemHealth Commercial	$13.10
Rate for Payer: Group Health Inc Commercial	$13.10
Rate for Payer: Group Health Inc Medicare	$9.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.10
Rate for Payer: Hamaspik Choice Inc Medicare	$13.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.03

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$7.50

Service Code	HCPCS J0690
Hospital Charge Code	0781345196
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$6.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$5.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.10
Rate for Payer: EmblemHealth Commercial	$3.75
Rate for Payer: Group Health Inc Commercial	$3.75
Rate for Payer: Group Health Inc Medicare	$2.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.75
Rate for Payer: Hamaspik Choice Inc Medicare	$3.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.88

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$1.92

Service Code	HCPCS J0690
Hospital Charge Code	2502110110
Hospital Revenue Code	250
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.96

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$2.61

Service Code	HCPCS J0690
Hospital Charge Code	6050561420
Hospital Revenue Code	250
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.30

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$1.64

Service Code	HCPCS J0690
Hospital Charge Code	0143992490
Hospital Revenue Code	250
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$1.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$1.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.12
Rate for Payer: EmblemHealth Commercial	$0.82
Rate for Payer: Group Health Inc Commercial	$0.82
Rate for Payer: Group Health Inc Medicare	$0.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.82
Rate for Payer: Hamaspik Choice Inc Medicare	$0.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.07

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$2.09

Service Code	HCPCS J0690
Hospital Charge Code	6332323710
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.04

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$2.61

Service Code	HCPCS J0690
Hospital Charge Code	6050561425
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.31

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$1.92

Service Code	HCPCS J0690
Hospital Charge Code	2502110110
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$1.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$1.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.31
Rate for Payer: EmblemHealth Commercial	$0.96
Rate for Payer: Group Health Inc Commercial	$0.96
Rate for Payer: Group Health Inc Medicare	$0.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.96
Rate for Payer: Hamaspik Choice Inc Medicare	$0.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.25

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$2.61

Service Code	HCPCS J0690
Hospital Charge Code	6050561425
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$2.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$1.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.78
Rate for Payer: EmblemHealth Commercial	$1.31
Rate for Payer: Group Health Inc Commercial	$1.31
Rate for Payer: Group Health Inc Medicare	$0.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.31
Rate for Payer: Hamaspik Choice Inc Medicare	$1.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.70

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$1.64

Service Code	HCPCS J0690
Hospital Charge Code	0143992490
Hospital Revenue Code	250
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.82

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$2.61

Service Code	HCPCS J0690
Hospital Charge Code	6050561420
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$2.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$1.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.77
Rate for Payer: EmblemHealth Commercial	$1.30
Rate for Payer: Group Health Inc Commercial	$1.30
Rate for Payer: Group Health Inc Medicare	$0.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1.30
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.70

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$2.09

Service Code	HCPCS J0690
Hospital Charge Code	6332323710
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$1.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$1.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.42
Rate for Payer: EmblemHealth Commercial	$1.04
Rate for Payer: Group Health Inc Commercial	$1.04
Rate for Payer: Group Health Inc Medicare	$0.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.04
Rate for Payer: Hamaspik Choice Inc Medicare	$1.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.36

CEFAZOLIN SODIUM 1 G IJ SOLR

Facility

$7.50

Service Code	HCPCS J0690
Hospital Charge Code	0781345196
Hospital Revenue Code	250
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.75

CEFAZOLIN SODIUM 2 G IJ SOLR (WRAPPED)

Facility

$7.31

Service Code	HCPCS J0690
Hospital Charge Code	6050562310
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$5.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$5.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.97
Rate for Payer: EmblemHealth Commercial	$3.65
Rate for Payer: Group Health Inc Commercial	$3.65
Rate for Payer: Group Health Inc Medicare	$2.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.65
Rate for Payer: Hamaspik Choice Inc Medicare	$3.65
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.75

CEFAZOLIN SODIUM 2 G IJ SOLR (WRAPPED)

Facility

$7.31

Service Code	HCPCS J0690
Hospital Charge Code	6050562315
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$5.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$5.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.97
Rate for Payer: EmblemHealth Commercial	$3.66
Rate for Payer: Group Health Inc Commercial	$3.66
Rate for Payer: Group Health Inc Medicare	$2.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.66
Rate for Payer: Hamaspik Choice Inc Medicare	$3.66
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.75

CEFAZOLIN SODIUM 2 G IJ SOLR (WRAPPED)

Facility

$7.02

Service Code	HCPCS J0690
Hospital Charge Code	0143913925
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$5.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$5.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.77
Rate for Payer: EmblemHealth Commercial	$3.51
Rate for Payer: Group Health Inc Commercial	$3.51
Rate for Payer: Group Health Inc Medicare	$2.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.51
Rate for Payer: Hamaspik Choice Inc Medicare	$3.51
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.56

CEFAZOLIN SODIUM 2 G IJ SOLR (WRAPPED)

Facility

$7.02

Service Code	HCPCS J0690
Hospital Charge Code	0143913901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$5.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$5.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.77
Rate for Payer: EmblemHealth Commercial	$3.51
Rate for Payer: Group Health Inc Commercial	$3.51
Rate for Payer: Group Health Inc Medicare	$2.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.51
Rate for Payer: Hamaspik Choice Inc Medicare	$3.51
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.56

CEFAZOLIN SODIUM 2 G IJ SOLR (WRAPPED)

Facility

$7.31

Service Code	HCPCS J0690
Hospital Charge Code	6050562315
Hospital Revenue Code	250
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$3.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.66

CEFAZOLIN SODIUM 2 G IJ SOLR (WRAPPED)

Facility

$7.02

Service Code	HCPCS J0690
Hospital Charge Code	0143913925
Hospital Revenue Code	250
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$3.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.51

CEFAZOLIN SODIUM 2 G IJ SOLR (WRAPPED)

Facility

$7.02

Service Code	HCPCS J0690
Hospital Charge Code	0143913901
Hospital Revenue Code	250
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$3.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.51

CEFAZOLIN SODIUM 2 G IJ SOLR (WRAPPED)

Facility

$7.31

Service Code	HCPCS J0690
Hospital Charge Code	6050562310
Hospital Revenue Code	250
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$3.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.65

Know your out-of-pocket cost for care.

All Charges