St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NALOXONE HCL 2 MG/2ML IJ SOSY

Facility

$19.80

Service Code	HCPCS J2312
Hospital Charge Code	7632933691
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$15.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.90
Rate for Payer: Aetna Government	$9.90
Rate for Payer: Brighton Health Commercial	$14.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.46
Rate for Payer: EmblemHealth Commercial	$9.90
Rate for Payer: Group Health Inc Commercial	$9.90
Rate for Payer: Group Health Inc Medicare	$6.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.90
Rate for Payer: Hamaspik Choice Inc Medicare	$9.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.87

NALOXONE HCL 4 MG/10ML IJ SOLN

Facility

$14.25

Service Code	HCPCS J2312
Hospital Charge Code	0409121901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$11.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.12
Rate for Payer: Aetna Government	$7.12
Rate for Payer: Brighton Health Commercial	$10.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.69
Rate for Payer: EmblemHealth Commercial	$7.12
Rate for Payer: Group Health Inc Commercial	$7.12
Rate for Payer: Group Health Inc Medicare	$4.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.12
Rate for Payer: Hamaspik Choice Inc Medicare	$7.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.26

NALOXONE HCL 4 MG/10ML IJ SOLN

Facility

$14.25

Service Code	HCPCS J2312
Hospital Charge Code	0409121901
Hospital Revenue Code	250
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.12

NALOXONE NYDOH KIT

Facility

$0.01

Service Code	HCPCS J2312
Hospital Charge Code	9999123479
Hospital Revenue Code	250
Max. Negotiated Rate	$0.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: EmblemHealth Commercial	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

NALOXONE NYDOH KIT

Facility

$0.01

Service Code	HCPCS J2312
Hospital Charge Code	9999123479
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01

NALTREXONE 380 MG IM SUSR

Facility

$1.00

Service Code	HCPCS J2315
Hospital Charge Code	6575730001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$0.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50

NALTREXONE 380 MG IM SUSR

Facility

$1.00

Service Code	HCPCS J2315
Hospital Charge Code	6575730001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$321.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.24
Rate for Payer: Aetna Government	$4.24
Rate for Payer: Affinity Essential Plan 1&2	$7.22
Rate for Payer: Affinity Essential Plan 3&4	$7.22
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.21
Rate for Payer: Amida Care Medicaid	$3.21
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$4.24
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$4.24
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Elderplan Medicare Advantage	$4.24
Rate for Payer: EmblemHealth Commercial	$4.24
Rate for Payer: EmblemHealth Essential Plan 1&2	$7.22
Rate for Payer: EmblemHealth Essential Plan 3&4	$3.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.21
Rate for Payer: Fidelis Essential Plan Aliesa	$7.22
Rate for Payer: Fidelis Essential Plan QHP	$7.22
Rate for Payer: Fidelis Medicare Advantage	$4.24
Rate for Payer: Fidelis Qualified Health Plan	$3.37
Rate for Payer: Group Health Inc Commercial	$4.24
Rate for Payer: Group Health Inc Medicare	$4.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.21
Rate for Payer: Hamaspik Choice Inc Medicare	$4.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$321.00
Rate for Payer: Healthfirst Essential Plan	$7.22
Rate for Payer: Healthfirst Medicare Advantage	$3.60
Rate for Payer: Healthfirst QHP	$5.23
Rate for Payer: Humana Medicare	$4.32
Rate for Payer: Senior Whole Health Medicare Advantage	$4.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3.21
Rate for Payer: SOMOS Essential	$7.22
Rate for Payer: United Healthcare Essential Plan 1&2	$7.22
Rate for Payer: United Healthcare Essential Plan 3&4	$3.53
Rate for Payer: United Healthcare Medicaid	$3.21
Rate for Payer: United Healthcare Medicare Advantage	$4.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.21
Rate for Payer: Wellcare Medicare	$4.03

NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OP SOLN

Facility

$0.63

Service Code	NDC 0065008515
Hospital Charge Code	0065008515
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31

NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OP SOLN

Facility

$0.63

Service Code	NDC 0065008515
Hospital Charge Code	0065008515
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.31
Rate for Payer: Aetna Government	$0.31
Rate for Payer: Brighton Health Commercial	$0.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.43
Rate for Payer: EmblemHealth Commercial	$0.31
Rate for Payer: Group Health Inc Commercial	$0.31
Rate for Payer: Group Health Inc Medicare	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.41

NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OP SOLN

Facility

$0.67

Service Code	NDC 0065008542
Hospital Charge Code	0065008542
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33

NAPHAZOLINE-PHENIRAMINE 0.025-0.3 % OP SOLN

Facility

$0.67

Service Code	NDC 0065008542
Hospital Charge Code	0065008542
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.33
Rate for Payer: Aetna Government	$0.33
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.45
Rate for Payer: EmblemHealth Commercial	$0.33
Rate for Payer: Group Health Inc Commercial	$0.33
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33
Rate for Payer: Hamaspik Choice Inc Medicare	$0.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.43

NAPHAZOLINE-PHENIRAMINE 0.027-0.315 % OP SOLN

Facility

$0.39

Service Code	NDC 1011902090
Hospital Charge Code	1011902090
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19

NAPHAZOLINE-PHENIRAMINE 0.027-0.315 % OP SOLN

Facility

$0.39

Service Code	NDC 1011902090
Hospital Charge Code	1011902090
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.19
Rate for Payer: Aetna Government	$0.19
Rate for Payer: Brighton Health Commercial	$0.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.26
Rate for Payer: EmblemHealth Commercial	$0.19
Rate for Payer: Group Health Inc Commercial	$0.19
Rate for Payer: Group Health Inc Medicare	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.19
Rate for Payer: Hamaspik Choice Inc Medicare	$0.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.25

NAPROXEN 250 MG PO TABS

Facility

$0.67

Service Code	NDC 7001013705
Hospital Charge Code	7001013705
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33

NAPROXEN 250 MG PO TABS

Facility

$0.78

Service Code	NDC 6846218801
Hospital Charge Code	6846218801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39

NAPROXEN 250 MG PO TABS

Facility

$0.67

Service Code	NDC 7001013705
Hospital Charge Code	7001013705
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.33
Rate for Payer: Aetna Government	$0.33
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.45
Rate for Payer: EmblemHealth Commercial	$0.33
Rate for Payer: Group Health Inc Commercial	$0.33
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33
Rate for Payer: Hamaspik Choice Inc Medicare	$0.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.43

NAPROXEN 250 MG PO TABS

Facility

$0.78

Service Code	NDC 5026859415
Hospital Charge Code	5026859415
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.62
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	$0.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
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

NAPROXEN 250 MG PO TABS

Facility

$0.78

Service Code	NDC 6846218801
Hospital Charge Code	6846218801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.62
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	$0.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
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	$0.50

NAPROXEN 250 MG PO TABS

Facility

$0.78

Service Code	NDC 5026859415
Hospital Charge Code	5026859415
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39

NAPROXEN 250 MG PO TABS

Facility

$0.78

Service Code	NDC 5026859411
Hospital Charge Code	5026859411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39

NAPROXEN 250 MG PO TABS

Facility

$0.78

Service Code	NDC 5026859411
Hospital Charge Code	5026859411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.62
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	$0.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
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

NAPROXEN 375 MG PO TABS

Facility

$0.99

Service Code	NDC 5026859515
Hospital Charge Code	5026859515
Hospital Revenue Code	250
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$0.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.49

NAPROXEN 375 MG PO TABS

Facility

$0.99

Service Code	NDC 5026859511
Hospital Charge Code	5026859511
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.49
Rate for Payer: Aetna Government	$0.49
Rate for Payer: Brighton Health Commercial	$0.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.67
Rate for Payer: EmblemHealth Commercial	$0.49
Rate for Payer: Group Health Inc Commercial	$0.49
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.49
Rate for Payer: Hamaspik Choice Inc Medicare	$0.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.64

NAPROXEN 375 MG PO TABS

Facility

$0.99

Service Code	NDC 5026859515
Hospital Charge Code	5026859515
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.49
Rate for Payer: Aetna Government	$0.49
Rate for Payer: Brighton Health Commercial	$0.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.67
Rate for Payer: EmblemHealth Commercial	$0.49
Rate for Payer: Group Health Inc Commercial	$0.49
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.49
Rate for Payer: Hamaspik Choice Inc Medicare	$0.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.64

NAPROXEN 375 MG PO TABS

Facility

$1.06

Service Code	NDC 6846218901
Hospital Charge Code	6846218901
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.53
Rate for Payer: Aetna Government	$0.53
Rate for Payer: Brighton Health Commercial	$0.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.72
Rate for Payer: EmblemHealth Commercial	$0.53
Rate for Payer: Group Health Inc Commercial	$0.53
Rate for Payer: Group Health Inc Medicare	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.53
Rate for Payer: Hamaspik Choice Inc Medicare	$0.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.69

Know your out-of-pocket cost for care.

All Charges