St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.36

Service Code	HCPCS J2405
Hospital Charge Code	6050561300
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Brighton Health Commercial	$0.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
Rate for Payer: EmblemHealth Commercial	$0.18
Rate for Payer: Group Health Inc Commercial	$0.18
Rate for Payer: Group Health Inc Medicare	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18
Rate for Payer: Hamaspik Choice Inc Medicare	$0.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.23

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.77

Service Code	HCPCS J2405
Hospital Charge Code	0409475503
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.77

Service Code	HCPCS J2405
Hospital Charge Code	0409475503
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
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	$0.52
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: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.50

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.54

Service Code	HCPCS J2405
Hospital Charge Code	3600001225
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Brighton Health Commercial	$0.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.37
Rate for Payer: EmblemHealth Commercial	$0.27
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.35

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.36

Service Code	HCPCS J2405
Hospital Charge Code	6050561305
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.54

Service Code	HCPCS J2405
Hospital Charge Code	3600001225
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.77

Service Code	HCPCS J2405
Hospital Charge Code	0409475518
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
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	$0.52
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: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.50

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.28

Service Code	HCPCS J2405
Hospital Charge Code	2315554731
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.28

Service Code	HCPCS J2405
Hospital Charge Code	2315554731
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Brighton Health Commercial	$0.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.19
Rate for Payer: EmblemHealth Commercial	$0.14
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.28

Service Code	HCPCS J2405
Hospital Charge Code	2315554742
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.36

Service Code	HCPCS J2405
Hospital Charge Code	6050561300
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.28

Service Code	HCPCS J2405
Hospital Charge Code	2315554742
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Brighton Health Commercial	$0.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.19
Rate for Payer: EmblemHealth Commercial	$0.14
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

ONDANSETRON HCL 4 MG/2ML IJ SOLN

Facility

$0.36

Service Code	HCPCS J2405
Hospital Charge Code	6050561305
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Brighton Health Commercial	$0.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
Rate for Payer: EmblemHealth Commercial	$0.18
Rate for Payer: Group Health Inc Commercial	$0.18
Rate for Payer: Group Health Inc Medicare	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.18
Rate for Payer: Hamaspik Choice Inc Medicare	$0.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.23

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$3.41

Service Code	HCPCS Q0162
Hospital Charge Code	0904707393
Hospital Revenue Code	250
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$3.28

Service Code	HCPCS Q0162
Hospital Charge Code	6068725286
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
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: Healthfirst CHP/FHP/Medicaid	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.13

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$3.28

Service Code	HCPCS Q0162
Hospital Charge Code	6068725286
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.64

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$3.28

Service Code	HCPCS Q0162
Hospital Charge Code	6068725240
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.64

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$3.41

Service Code	HCPCS Q0162
Hospital Charge Code	0904707341
Hospital Revenue Code	250
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$1.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$3.41

Service Code	HCPCS Q0162
Hospital Charge Code	0904707341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$2.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.32
Rate for Payer: EmblemHealth Commercial	$1.70
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.21

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$4.80

Service Code	HCPCS Q0162
Hospital Charge Code	0054006447
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$3.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$3.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.26
Rate for Payer: EmblemHealth Commercial	$2.40
Rate for Payer: Group Health Inc Commercial	$2.40
Rate for Payer: Group Health Inc Medicare	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.40
Rate for Payer: Hamaspik Choice Inc Medicare	$2.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.12

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$3.41

Service Code	HCPCS Q0162
Hospital Charge Code	0904707393
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$2.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.32
Rate for Payer: EmblemHealth Commercial	$1.70
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.21

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$4.80

Service Code	HCPCS Q0162
Hospital Charge Code	0054006447
Hospital Revenue Code	250
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.40

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$4.80

Service Code	HCPCS Q0162
Hospital Charge Code	6516269179
Hospital Revenue Code	250
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.40

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$4.80

Service Code	HCPCS Q0162
Hospital Charge Code	6516269179
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$3.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$3.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.26
Rate for Payer: EmblemHealth Commercial	$2.40
Rate for Payer: Group Health Inc Commercial	$2.40
Rate for Payer: Group Health Inc Medicare	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.40
Rate for Payer: Hamaspik Choice Inc Medicare	$2.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.12

ONDANSETRON HCL 4 MG/5ML PO SOLN

Facility

$3.06

Service Code	HCPCS Q0162
Hospital Charge Code	5026864711
Hospital Revenue Code	250
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$1.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.53

Know your out-of-pocket cost for care.

All Charges