St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HEPARIN 2,000 UNITS/SODIUM CHLORIDE 0.9%

Facility

$34.08

Service Code	HCPCS J1644
Hospital Charge Code	41655107
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$22.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$20.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.60
Rate for Payer: Group Health Inc Commercial	$17.04
Rate for Payer: Group Health Inc Medicare	$11.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.04
Rate for Payer: Hamaspik Choice Inc Medicare	$17.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.15

HEPARIN 2,000 UNITS/SODIUM CHLORIDE 0.9%

Facility

$34.08

Service Code	HCPCS J1644
Hospital Charge Code	41655107
Hospital Revenue Code	636
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$17.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.04
Rate for Payer: Hamaspik Choice Inc Medicare	$17.04

HEPARIN 2,000 UNITS/SODIUM CHLORIDE 0.9%

Facility

$34.08

Service Code	HCPCS J1644
Hospital Charge Code	41645107
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$22.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$20.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.60
Rate for Payer: Group Health Inc Commercial	$17.04
Rate for Payer: Group Health Inc Medicare	$11.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.04
Rate for Payer: Hamaspik Choice Inc Medicare	$17.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.15

HEPARIN 25,000 UNITS/DEXTROSE 5% 250 ML

Facility

$0.47

Service Code	HCPCS J1644
Hospital Charge Code	41642251
Hospital Revenue Code	636
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.27
Rate for Payer: Group Health Inc Commercial	$0.24
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24
Rate for Payer: Hamaspik Choice Inc Medicare	$0.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.31

HEPARIN 25,000 UNITS/DEXTROSE 5% 250 ML

Facility

$0.47

Service Code	HCPCS J1644
Hospital Charge Code	41652251
Hospital Revenue Code	636
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.27
Rate for Payer: Group Health Inc Commercial	$0.24
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24
Rate for Payer: Hamaspik Choice Inc Medicare	$0.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.31

HEPARIN 25,000 UNITS/DEXTROSE 5% 250 ML

Facility

$0.47

Service Code	HCPCS J1644
Hospital Charge Code	41652251
Hospital Revenue Code	636
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24
Rate for Payer: Hamaspik Choice Inc Medicare	$0.24

HEPARIN 25,000 UNITS/DEXTROSE 5% 250 ML

Facility

$0.47

Service Code	HCPCS J1644
Hospital Charge Code	41642251
Hospital Revenue Code	636
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.24
Rate for Payer: Hamaspik Choice Inc Medicare	$0.24

HEPARIN 5000 U/D5W 250ML

Facility

$0.49

Service Code	HCPCS J1644
Hospital Charge Code	41647933
Hospital Revenue Code	636
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.28
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.32

HEPARIN 5000 U/D5W 250ML

Facility

$0.49

Service Code	HCPCS J1644
Hospital Charge Code	41647933
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25

HEPARIN 5000 U/D5W 250ML

Facility

$0.49

Service Code	HCPCS J1644
Hospital Charge Code	41657933
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25

HEPARIN 5000 U/D5W 250ML

Facility

$0.49

Service Code	HCPCS J1644
Hospital Charge Code	41657933
Hospital Revenue Code	636
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.28
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.32

HEPARIN 5,000 UNITS/0.5 ML INJ

Facility

$5.00

Service Code	HCPCS J1644
Hospital Charge Code	41654959
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$3.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.88
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

HEPARIN 5,000 UNITS/0.5 ML INJ

Facility

$5.00

Service Code	HCPCS J1644
Hospital Charge Code	41644959
Hospital Revenue Code	636
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$2.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50

HEPARIN 5,000 UNITS/0.5 ML INJ

Facility

$5.00

Service Code	HCPCS J1644
Hospital Charge Code	41644959
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$3.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.88
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

HEPARIN 5,000 UNITS/0.5 ML INJ

Facility

$5.00

Service Code	HCPCS J1644
Hospital Charge Code	41654959
Hospital Revenue Code	636
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$2.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50

HEPARIN 5000 UNITS/1ML INJ

Facility

$2.00

Service Code	HCPCS J1644
Hospital Charge Code	41656026
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

HEPARIN 5000 UNITS/1ML INJ

Facility

$2.00

Service Code	HCPCS J1644
Hospital Charge Code	41646026
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

HEPARIN 5000 UNITS/1ML INJ

Facility

$2.00

Service Code	HCPCS J1644
Hospital Charge Code	41656026
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

HEPARIN 5000 UNITS/1ML INJ

Facility

$2.00

Service Code	HCPCS J1644
Hospital Charge Code	41646026
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

HEPARIN 5,000 UNITS/ML INJ 10 ML (DIALYS

Facility

$0.30

Service Code	HCPCS J1644
Hospital Charge Code	41654871
Hospital Revenue Code	636
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.17
Rate for Payer: Group Health Inc Commercial	$0.15
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.20

HEPARIN 5,000 UNITS/ML INJ 10 ML (DIALYS

Facility

$0.30

Service Code	HCPCS J1644
Hospital Charge Code	41644871
Hospital Revenue Code	636
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.17
Rate for Payer: Group Health Inc Commercial	$0.15
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.20

HEPARIN 5,000 UNITS/ML INJ 10 ML (DIALYS

Facility

$0.30

Service Code	HCPCS J1644
Hospital Charge Code	41654871
Hospital Revenue Code	636
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15

HEPARIN 5,000 UNITS/ML INJ 10 ML (DIALYS

Facility

$0.30

Service Code	HCPCS J1644
Hospital Charge Code	41644871
Hospital Revenue Code	636
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15

HEPARIN 5,000 UNITS/ML INJ 1 ML

Facility

$0.26

Service Code	HCPCS J1644
Hospital Charge Code	41643261
Hospital Revenue Code	636
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.15
Rate for Payer: Group Health Inc Commercial	$0.13
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.17

HEPARIN 5,000 UNITS/ML INJ 1 ML

Facility

$0.26

Service Code	HCPCS J1644
Hospital Charge Code	41653261
Hospital Revenue Code	636
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.15
Rate for Payer: Group Health Inc Commercial	$0.13
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.29
Rate for Payer: SOMOS Essential	$0.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.17

Know your out-of-pocket cost for care.

All Charges