St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

O.R. procedure for other complications of treatment

Facility

$148,282.11

Service Code	APR-DRG 7914
Min. Negotiated Rate	$65,903.16
Max. Negotiated Rate	$148,282.11
Rate for Payer: Affinity Essential Plan 1&2	$148,282.11
Rate for Payer: Affinity Essential Plan 3&4	$148,282.11
Rate for Payer: Affinity Medicaid/CHP/HARP	$65,903.16
Rate for Payer: Amida Care Medicaid	$65,903.16
Rate for Payer: EmblemHealth Essential Plan 1&2	$148,282.11
Rate for Payer: EmblemHealth Essential Plan 3&4	$65,903.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$65,903.16
Rate for Payer: Fidelis Qualified Health Plan	$79,083.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$65,903.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$65,903.16
Rate for Payer: Healthfirst Commercial	$113,474.00
Rate for Payer: Healthfirst Essential Plan	$148,282.11
Rate for Payer: Healthfirst QHP	$71,888.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$65,903.16
Rate for Payer: SOMOS Essential	$148,282.11
Rate for Payer: United Healthcare Essential Plan 1&2	$148,282.11
Rate for Payer: United Healthcare Essential Plan 3&4	$148,282.11
Rate for Payer: United Healthcare Medicaid	$65,903.16
Rate for Payer: Wellcare CHP/FHP/Medicaid	$65,903.16

O.R. procedure for other complications of treatment

Facility

$46,930.84

Service Code	APR-DRG 7911
Min. Negotiated Rate	$9,871.00
Max. Negotiated Rate	$46,930.84
Rate for Payer: Affinity Essential Plan 1&2	$46,930.84
Rate for Payer: Affinity Essential Plan 3&4	$46,930.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,858.15
Rate for Payer: Amida Care Medicaid	$20,858.15
Rate for Payer: EmblemHealth Essential Plan 1&2	$46,930.84
Rate for Payer: EmblemHealth Essential Plan 3&4	$20,858.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,858.15
Rate for Payer: Fidelis Qualified Health Plan	$25,029.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,858.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,858.15
Rate for Payer: Healthfirst Commercial	$17,813.00
Rate for Payer: Healthfirst Essential Plan	$46,930.84
Rate for Payer: Healthfirst QHP	$9,871.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,858.15
Rate for Payer: SOMOS Essential	$46,930.84
Rate for Payer: United Healthcare Essential Plan 1&2	$46,930.84
Rate for Payer: United Healthcare Essential Plan 3&4	$46,930.84
Rate for Payer: United Healthcare Medicaid	$20,858.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,858.15

O.R. procedure for other complications of treatment

Facility

$79,047.29

Service Code	APR-DRG 7913
Min. Negotiated Rate	$28,250.00
Max. Negotiated Rate	$79,047.29
Rate for Payer: Affinity Essential Plan 1&2	$79,047.29
Rate for Payer: Affinity Essential Plan 3&4	$79,047.29
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,132.13
Rate for Payer: Amida Care Medicaid	$35,132.13
Rate for Payer: EmblemHealth Essential Plan 1&2	$79,047.29
Rate for Payer: EmblemHealth Essential Plan 3&4	$35,132.13
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,132.13
Rate for Payer: Fidelis Qualified Health Plan	$42,158.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,132.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,132.13
Rate for Payer: Healthfirst Commercial	$47,217.00
Rate for Payer: Healthfirst Essential Plan	$79,047.29
Rate for Payer: Healthfirst QHP	$28,250.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,132.13
Rate for Payer: SOMOS Essential	$79,047.29
Rate for Payer: United Healthcare Essential Plan 1&2	$79,047.29
Rate for Payer: United Healthcare Essential Plan 3&4	$79,047.29
Rate for Payer: United Healthcare Medicaid	$35,132.13
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,132.13

O.R. procedure for other complications of treatment

Facility

$57,048.91

Service Code	APR-DRG 7912
Min. Negotiated Rate	$15,588.00
Max. Negotiated Rate	$57,048.91
Rate for Payer: Affinity Essential Plan 1&2	$57,048.91
Rate for Payer: Affinity Essential Plan 3&4	$57,048.91
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,355.07
Rate for Payer: Amida Care Medicaid	$25,355.07
Rate for Payer: EmblemHealth Essential Plan 1&2	$57,048.91
Rate for Payer: EmblemHealth Essential Plan 3&4	$25,355.07
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,355.07
Rate for Payer: Fidelis Qualified Health Plan	$30,426.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,355.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,355.07
Rate for Payer: Healthfirst Commercial	$27,073.00
Rate for Payer: Healthfirst Essential Plan	$57,048.91
Rate for Payer: Healthfirst QHP	$15,588.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,355.07
Rate for Payer: SOMOS Essential	$57,048.91
Rate for Payer: United Healthcare Essential Plan 1&2	$57,048.91
Rate for Payer: United Healthcare Essential Plan 3&4	$57,048.91
Rate for Payer: United Healthcare Medicaid	$25,355.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,355.07

OSELTAMIVIR PHOSPHATE 30 MG PO CAPS

Facility

$16.72

Service Code	NDC 0004080285
Hospital Charge Code	0004080285
Hospital Revenue Code	250
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$13.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.36
Rate for Payer: Aetna Government	$8.36
Rate for Payer: Brighton Health Commercial	$12.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.37
Rate for Payer: EmblemHealth Commercial	$8.36
Rate for Payer: Group Health Inc Commercial	$8.36
Rate for Payer: Group Health Inc Medicare	$5.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.36
Rate for Payer: Hamaspik Choice Inc Medicare	$8.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.87

OSELTAMIVIR PHOSPHATE 30 MG PO CAPS

Facility

$14.18

Service Code	NDC 4778146813
Hospital Charge Code	4778146813
Hospital Revenue Code	250
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09

OSELTAMIVIR PHOSPHATE 30 MG PO CAPS

Facility

$16.72

Service Code	NDC 0004080285
Hospital Charge Code	0004080285
Hospital Revenue Code	250
Min. Negotiated Rate	$8.36
Max. Negotiated Rate	$8.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.36

OSELTAMIVIR PHOSPHATE 30 MG PO CAPS

Facility

$14.18

Service Code	NDC 4778146813
Hospital Charge Code	4778146813
Hospital Revenue Code	250
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$11.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.09
Rate for Payer: Aetna Government	$7.09
Rate for Payer: Brighton Health Commercial	$10.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.64
Rate for Payer: EmblemHealth Commercial	$7.09
Rate for Payer: Group Health Inc Commercial	$7.09
Rate for Payer: Group Health Inc Medicare	$4.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09
Rate for Payer: Hamaspik Choice Inc Medicare	$7.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.22

OSELTAMIVIR PHOSPHATE 30 MG PO CAPS

Facility

$14.18

Service Code	NDC 7220504211
Hospital Charge Code	7220504211
Hospital Revenue Code	250
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09

OSELTAMIVIR PHOSPHATE 30 MG PO CAPS

Facility

$14.18

Service Code	NDC 7220504211
Hospital Charge Code	7220504211
Hospital Revenue Code	250
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$11.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.09
Rate for Payer: Aetna Government	$7.09
Rate for Payer: Brighton Health Commercial	$10.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.64
Rate for Payer: EmblemHealth Commercial	$7.09
Rate for Payer: Group Health Inc Commercial	$7.09
Rate for Payer: Group Health Inc Medicare	$4.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09
Rate for Payer: Hamaspik Choice Inc Medicare	$7.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.22

OSELTAMIVIR PHOSPHATE 30 MG PO CAPS

Facility

$14.18

Service Code	NDC 6818067511
Hospital Charge Code	6818067511
Hospital Revenue Code	250
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$11.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.09
Rate for Payer: Aetna Government	$7.09
Rate for Payer: Brighton Health Commercial	$10.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.64
Rate for Payer: EmblemHealth Commercial	$7.09
Rate for Payer: Group Health Inc Commercial	$7.09
Rate for Payer: Group Health Inc Medicare	$4.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09
Rate for Payer: Hamaspik Choice Inc Medicare	$7.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.22

OSELTAMIVIR PHOSPHATE 30 MG PO CAPS

Facility

$14.18

Service Code	NDC 6818067511
Hospital Charge Code	6818067511
Hospital Revenue Code	250
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09

OSELTAMIVIR PHOSPHATE 45 MG PO CAPS

Facility

$14.18

Service Code	NDC 6233241410
Hospital Charge Code	6233241410
Hospital Revenue Code	250
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09

OSELTAMIVIR PHOSPHATE 45 MG PO CAPS

Facility

$14.18

Service Code	NDC 6818067611
Hospital Charge Code	6818067611
Hospital Revenue Code	250
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$11.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.09
Rate for Payer: Aetna Government	$7.09
Rate for Payer: Brighton Health Commercial	$10.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.64
Rate for Payer: EmblemHealth Commercial	$7.09
Rate for Payer: Group Health Inc Commercial	$7.09
Rate for Payer: Group Health Inc Medicare	$4.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09
Rate for Payer: Hamaspik Choice Inc Medicare	$7.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.22

OSELTAMIVIR PHOSPHATE 45 MG PO CAPS

Facility

$14.18

Service Code	NDC 6818067611
Hospital Charge Code	6818067611
Hospital Revenue Code	250
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09

OSELTAMIVIR PHOSPHATE 45 MG PO CAPS

Facility

$14.18

Service Code	NDC 6233241410
Hospital Charge Code	6233241410
Hospital Revenue Code	250
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$11.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.09
Rate for Payer: Aetna Government	$7.09
Rate for Payer: Brighton Health Commercial	$10.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.64
Rate for Payer: EmblemHealth Commercial	$7.09
Rate for Payer: Group Health Inc Commercial	$7.09
Rate for Payer: Group Health Inc Medicare	$4.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.09
Rate for Payer: Hamaspik Choice Inc Medicare	$7.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.22

OSELTAMIVIR PHOSPHATE 45 MG PO CAPS

Facility

$16.72

Service Code	NDC 0004080185
Hospital Charge Code	0004080185
Hospital Revenue Code	250
Min. Negotiated Rate	$8.36
Max. Negotiated Rate	$8.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.36

OSELTAMIVIR PHOSPHATE 45 MG PO CAPS

Facility

$16.72

Service Code	NDC 0004080185
Hospital Charge Code	0004080185
Hospital Revenue Code	250
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$13.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.36
Rate for Payer: Aetna Government	$8.36
Rate for Payer: Brighton Health Commercial	$12.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.37
Rate for Payer: EmblemHealth Commercial	$8.36
Rate for Payer: Group Health Inc Commercial	$8.36
Rate for Payer: Group Health Inc Medicare	$5.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.36
Rate for Payer: Hamaspik Choice Inc Medicare	$8.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.87

OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR

Facility

$2.73

Service Code	NDC 2724113909
Hospital Charge Code	2724113909
Hospital Revenue Code	250
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$1.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.37

OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR

Facility

$2.73

Service Code	NDC 2724113909
Hospital Charge Code	2724113909
Hospital Revenue Code	250
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$2.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.37
Rate for Payer: Aetna Government	$1.37
Rate for Payer: Brighton Health Commercial	$2.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.86
Rate for Payer: EmblemHealth Commercial	$1.37
Rate for Payer: Group Health Inc Commercial	$1.37
Rate for Payer: Group Health Inc Medicare	$0.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.37
Rate for Payer: Hamaspik Choice Inc Medicare	$1.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.78

OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR

Facility

$3.04

Service Code	NDC 0004082205
Hospital Charge Code	0004082205
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52

OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR

Facility

$3.04

Service Code	NDC 0004082205
Hospital Charge Code	0004082205
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$2.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.52
Rate for Payer: Aetna Government	$1.52
Rate for Payer: Brighton Health Commercial	$2.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.07
Rate for Payer: EmblemHealth Commercial	$1.52
Rate for Payer: Group Health Inc Commercial	$1.52
Rate for Payer: Group Health Inc Medicare	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.97

OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR

Facility

$2.73

Service Code	NDC 6818067801
Hospital Charge Code	6818067801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$2.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.36
Rate for Payer: Aetna Government	$1.36
Rate for Payer: Brighton Health Commercial	$2.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.86
Rate for Payer: EmblemHealth Commercial	$1.36
Rate for Payer: Group Health Inc Commercial	$1.36
Rate for Payer: Group Health Inc Medicare	$0.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.36
Rate for Payer: Hamaspik Choice Inc Medicare	$1.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.77

OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR

Facility

$2.73

Service Code	NDC 7071011656
Hospital Charge Code	7071011656
Hospital Revenue Code	250
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$1.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.37

OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR

Facility

$2.73

Service Code	NDC 7071011656
Hospital Charge Code	7071011656
Hospital Revenue Code	250
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$2.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.37
Rate for Payer: Aetna Government	$1.37
Rate for Payer: Brighton Health Commercial	$2.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.86
Rate for Payer: EmblemHealth Commercial	$1.37
Rate for Payer: Group Health Inc Commercial	$1.37
Rate for Payer: Group Health Inc Medicare	$0.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.37
Rate for Payer: Hamaspik Choice Inc Medicare	$1.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.78

Know your out-of-pocket cost for care.

All Charges