St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

OBESITY

Facility

$214.07

Service Code	EAPG 00695
Min. Negotiated Rate	$155.06
Max. Negotiated Rate	$214.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$155.06
Rate for Payer: Healthfirst Commercial	$214.07

OBINUTUZUMAB 1000 MG/40ML IV SOLN

Facility

$247.26

Service Code	HCPCS J9301
Hospital Charge Code	5024207001
Hospital Revenue Code	258
Min. Negotiated Rate	$55.30
Max. Negotiated Rate	$197.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$135.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$79.00
Rate for Payer: Aetna Government	$79.00
Rate for Payer: Affinity Essential Plan 1&2	$55.30
Rate for Payer: Affinity Essential Plan 3&4	$55.30
Rate for Payer: Affinity Medicaid/CHP/HARP	$55.30
Rate for Payer: Brighton Health Commercial	$185.44
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$79.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$197.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.13
Rate for Payer: Elderplan Medicare Advantage	$79.00
Rate for Payer: EmblemHealth Commercial	$79.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$71.10
Rate for Payer: Fidelis Essential Plan Aliesa	$67.15
Rate for Payer: Fidelis Essential Plan QHP	$70.31
Rate for Payer: Fidelis Medicare Advantage	$79.00
Rate for Payer: Fidelis Qualified Health Plan	$70.31
Rate for Payer: Group Health Inc Commercial	$79.00
Rate for Payer: Group Health Inc Medicare	$79.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.00
Rate for Payer: Hamaspik Choice Inc Medicare	$79.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$79.00
Rate for Payer: Healthfirst Medicare Advantage	$67.15
Rate for Payer: Healthfirst QHP	$79.00
Rate for Payer: Humana Medicare	$80.58
Rate for Payer: Senior Whole Health Medicare Advantage	$79.00
Rate for Payer: United Healthcare Medicare Advantage	$79.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$160.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$75.05
Rate for Payer: Wellcare Medicare	$75.05

OBINUTUZUMAB 1000 MG/40ML IV SOLN

Facility

$247.26

Service Code	HCPCS J9301
Hospital Charge Code	5024207001
Hospital Revenue Code	258
Min. Negotiated Rate	$123.63
Max. Negotiated Rate	$123.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.63

OBSERVATION

Facility

$49.83

Service Code	EAPG 00450
Min. Negotiated Rate	$37.03
Max. Negotiated Rate	$49.83
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$37.03
Rate for Payer: Healthfirst Commercial	$49.83

OBSTETRICAL PROCEDURES

Facility

$1,300.64

Service Code	EAPG 00205
Min. Negotiated Rate	$1,300.64
Max. Negotiated Rate	$1,300.64
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,300.64

OBSTETRICAL ULTRASOUND

Facility

$221.78

Service Code	EAPG 00470
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$221.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$162.00
Rate for Payer: Healthfirst Commercial	$221.78

OCCUPATIONAL THERAPY

Facility

$230.84

Service Code	EAPG 00270
Min. Negotiated Rate	$166.63
Max. Negotiated Rate	$230.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$166.63
Rate for Payer: Healthfirst Commercial	$230.84

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$11.93

Service Code	HCPCS J2354
Hospital Charge Code	6332337600
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$9.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$8.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.11
Rate for Payer: EmblemHealth Commercial	$5.96
Rate for Payer: Group Health Inc Commercial	$5.96
Rate for Payer: Group Health Inc Medicare	$4.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.96
Rate for Payer: Hamaspik Choice Inc Medicare	$5.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.75

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$7.80

Service Code	HCPCS J2354
Hospital Charge Code	0641617510
Hospital Revenue Code	250
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.90

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$4.08

Service Code	HCPCS J2354
Hospital Charge Code	6332337604
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$3.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$3.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.77
Rate for Payer: EmblemHealth Commercial	$2.04
Rate for Payer: Group Health Inc Commercial	$2.04
Rate for Payer: Group Health Inc Medicare	$1.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.65

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$32.86

Service Code	HCPCS J2354
Hospital Charge Code	0078018101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$26.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$24.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.34
Rate for Payer: EmblemHealth Commercial	$16.43
Rate for Payer: Group Health Inc Commercial	$16.43
Rate for Payer: Group Health Inc Medicare	$11.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.43
Rate for Payer: Hamaspik Choice Inc Medicare	$16.43
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.36

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$7.80

Service Code	HCPCS J2354
Hospital Charge Code	2315568831
Hospital Revenue Code	250
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.90

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$32.86

Service Code	HCPCS J2354
Hospital Charge Code	0078018101
Hospital Revenue Code	250
Min. Negotiated Rate	$16.43
Max. Negotiated Rate	$16.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.43

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$7.80

Service Code	HCPCS J2354
Hospital Charge Code	2315568831
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$6.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$5.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.30
Rate for Payer: EmblemHealth Commercial	$3.90
Rate for Payer: Group Health Inc Commercial	$3.90
Rate for Payer: Group Health Inc Medicare	$2.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.90
Rate for Payer: Hamaspik Choice Inc Medicare	$3.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.07

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$11.93

Service Code	HCPCS J2354
Hospital Charge Code	6332337601
Hospital Revenue Code	250
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$5.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.96

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$4.08

Service Code	HCPCS J2354
Hospital Charge Code	6332337604
Hospital Revenue Code	250
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$7.80

Service Code	HCPCS J2354
Hospital Charge Code	0641617510
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$6.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$5.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.30
Rate for Payer: EmblemHealth Commercial	$3.90
Rate for Payer: Group Health Inc Commercial	$3.90
Rate for Payer: Group Health Inc Medicare	$2.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.90
Rate for Payer: Hamaspik Choice Inc Medicare	$3.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.07

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$11.93

Service Code	HCPCS J2354
Hospital Charge Code	6332337601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$9.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$8.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.11
Rate for Payer: EmblemHealth Commercial	$5.96
Rate for Payer: Group Health Inc Commercial	$5.96
Rate for Payer: Group Health Inc Medicare	$4.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.96
Rate for Payer: Hamaspik Choice Inc Medicare	$5.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.75

OCTREOTIDE ACETATE 100 MCG/ML IJ SOLN

Facility

$11.93

Service Code	HCPCS J2354
Hospital Charge Code	6332337600
Hospital Revenue Code	250
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$5.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.96

OCTREOTIDE ACETATE 100 MCG/ML SC SOSY

Facility

$9.48

Service Code	HCPCS J2354
Hospital Charge Code	6745724500
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$7.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$7.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.45
Rate for Payer: EmblemHealth Commercial	$4.74
Rate for Payer: Group Health Inc Commercial	$4.74
Rate for Payer: Group Health Inc Medicare	$3.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.74
Rate for Payer: Hamaspik Choice Inc Medicare	$4.74
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.16

OCTREOTIDE ACETATE 100 MCG/ML SC SOSY

Facility

$9.48

Service Code	HCPCS J2354
Hospital Charge Code	6745724500
Hospital Revenue Code	250
Min. Negotiated Rate	$4.74
Max. Negotiated Rate	$4.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.74

OCTREOTIDE ACETATE 200 MCG/ML IJ SOLN

Facility

$16.32

Service Code	HCPCS J2354
Hospital Charge Code	0641617701
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$13.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$12.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.10
Rate for Payer: EmblemHealth Commercial	$8.16
Rate for Payer: Group Health Inc Commercial	$8.16
Rate for Payer: Group Health Inc Medicare	$5.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.16
Rate for Payer: Hamaspik Choice Inc Medicare	$8.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.61

OCTREOTIDE ACETATE 200 MCG/ML IJ SOLN

Facility

$16.32

Service Code	HCPCS J2354
Hospital Charge Code	0641617701
Hospital Revenue Code	250
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$8.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.16

OCTREOTIDE ACETATE 20 MG IM KIT

Facility

$5.00

Service Code	HCPCS J2353
Hospital Charge Code	0078081881
Hospital Revenue Code	250
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$2.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50

OCTREOTIDE ACETATE 20 MG IM KIT

Facility

$5.00

Service Code	HCPCS J2353
Hospital Charge Code	0078081881
Hospital Revenue Code	250
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$15,804.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$203.58
Rate for Payer: Aetna Government	$203.58
Rate for Payer: Affinity Essential Plan 1&2	$355.59
Rate for Payer: Affinity Essential Plan 3&4	$355.59
Rate for Payer: Affinity Medicaid/CHP/HARP	$158.04
Rate for Payer: Amida Care Medicaid	$158.04
Rate for Payer: Brighton Health Commercial	$3.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$203.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Elderplan Medicare Advantage	$203.58
Rate for Payer: EmblemHealth Commercial	$203.58
Rate for Payer: EmblemHealth Essential Plan 1&2	$355.59
Rate for Payer: EmblemHealth Essential Plan 3&4	$158.04
Rate for Payer: Fidelis CHP/HARP/Medicaid	$158.04
Rate for Payer: Fidelis Essential Plan Aliesa	$355.59
Rate for Payer: Fidelis Essential Plan QHP	$355.59
Rate for Payer: Fidelis Medicare Advantage	$203.58
Rate for Payer: Fidelis Qualified Health Plan	$165.94
Rate for Payer: Group Health Inc Commercial	$203.58
Rate for Payer: Group Health Inc Medicare	$203.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.04
Rate for Payer: Hamaspik Choice Inc Medicare	$203.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$15,804.00
Rate for Payer: Healthfirst Essential Plan	$355.59
Rate for Payer: Healthfirst Medicare Advantage	$173.04
Rate for Payer: Healthfirst QHP	$257.61
Rate for Payer: Humana Medicare	$207.65
Rate for Payer: Senior Whole Health Medicare Advantage	$203.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$158.04
Rate for Payer: SOMOS Essential	$355.59
Rate for Payer: United Healthcare Essential Plan 1&2	$355.59
Rate for Payer: United Healthcare Essential Plan 3&4	$173.84
Rate for Payer: United Healthcare Medicaid	$158.04
Rate for Payer: United Healthcare Medicare Advantage	$203.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$158.04
Rate for Payer: Wellcare Medicare	$193.40

Know your out-of-pocket cost for care.

All Charges