St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13

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	$0.13
Max. Negotiated Rate	$0.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13

HEPARIN ANTI-XA

Facility

$32.73

Service Code	HCPCS 85520
Hospital Charge Code	40629219
Hospital Revenue Code	300
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$24.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.09
Rate for Payer: Aetna Government	$13.09
Rate for Payer: Affinity Essential Plan 1&2	$9.16
Rate for Payer: Affinity Essential Plan 3&4	$9.16
Rate for Payer: Affinity Medicaid/CHP/HARP	$9.16
Rate for Payer: Brighton Health Commercial	$24.55
Rate for Payer: Cash Price	$13.09
Rate for Payer: Cash Price	$13.09
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.62
Rate for Payer: Elderplan Medicare Advantage	$13.09
Rate for Payer: EmblemHealth Commercial	$13.09
Rate for Payer: Fidelis Essential Plan Aliesa	$11.13
Rate for Payer: Fidelis Essential Plan QHP	$11.65
Rate for Payer: Fidelis Medicare Advantage	$13.09
Rate for Payer: Fidelis Qualified Health Plan	$11.65
Rate for Payer: Group Health Inc Commercial	$13.09
Rate for Payer: Group Health Inc Medicare	$13.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.36
Rate for Payer: Hamaspik Choice Inc Medicare	$13.09
Rate for Payer: Healthfirst Medicare Advantage	$13.09
Rate for Payer: Healthfirst QHP	$13.09
Rate for Payer: Humana Medicare	$13.35
Rate for Payer: Senior Whole Health Medicare Advantage	$13.09
Rate for Payer: United Healthcare Commercial	$16.59
Rate for Payer: United Healthcare Medicare Advantage	$13.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.47
Rate for Payer: Wellcare Medicare	$11.78

HEPARIN ANTI-XA

Facility

$32.73

Service Code	HCPCS 85520
Hospital Charge Code	40629219
Hospital Revenue Code	300
Rate for Payer: Cash Price	$13.09

HEPARIN FLUSH LOCK 100 UNITS/ML INJ 3 ML

Facility

$1.47

Service Code	HCPCS J1642
Hospital Charge Code	41653303
Hospital Revenue Code	636
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.85
Rate for Payer: Group Health Inc Commercial	$0.74
Rate for Payer: Group Health Inc Medicare	$0.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.74
Rate for Payer: Hamaspik Choice Inc Medicare	$0.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.02
Rate for Payer: SOMOS Essential	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.96

HEPARIN FLUSH LOCK 100 UNITS/ML INJ 3 ML

Facility

$1.47

Service Code	HCPCS J1642
Hospital Charge Code	41653303
Hospital Revenue Code	636
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.74
Rate for Payer: Hamaspik Choice Inc Medicare	$0.74

HEPARIN FLUSH LOCK 100 UNITS/ML INJ 3 ML

Facility

$1.47

Service Code	HCPCS J1642
Hospital Charge Code	41643303
Hospital Revenue Code	636
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.85
Rate for Payer: Group Health Inc Commercial	$0.74
Rate for Payer: Group Health Inc Medicare	$0.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.74
Rate for Payer: Hamaspik Choice Inc Medicare	$0.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.02
Rate for Payer: SOMOS Essential	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.96

HEPARIN FLUSH LOCK 100 UNITS/ML INJ 3 ML

Facility

$1.47

Service Code	HCPCS J1642
Hospital Charge Code	41643303
Hospital Revenue Code	636
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.74
Rate for Payer: Hamaspik Choice Inc Medicare	$0.74

HEPARIN INDUCED PLATELET

Facility

$45.93

Service Code	HCPCS 86022
Hospital Charge Code	40629227
Hospital Revenue Code	300
Min. Negotiated Rate	$12.86
Max. Negotiated Rate	$34.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.37
Rate for Payer: Aetna Government	$18.37
Rate for Payer: Affinity Essential Plan 1&2	$12.86
Rate for Payer: Affinity Essential Plan 3&4	$12.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$12.86
Rate for Payer: Brighton Health Commercial	$34.45
Rate for Payer: Cash Price	$18.37
Rate for Payer: Cash Price	$18.37
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$18.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.71
Rate for Payer: Elderplan Medicare Advantage	$18.37
Rate for Payer: EmblemHealth Commercial	$18.37
Rate for Payer: Fidelis Essential Plan Aliesa	$15.61
Rate for Payer: Fidelis Essential Plan QHP	$16.35
Rate for Payer: Fidelis Medicare Advantage	$18.37
Rate for Payer: Fidelis Qualified Health Plan	$16.35
Rate for Payer: Group Health Inc Commercial	$18.37
Rate for Payer: Group Health Inc Medicare	$18.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.96
Rate for Payer: Hamaspik Choice Inc Medicare	$18.37
Rate for Payer: Healthfirst Medicare Advantage	$18.37
Rate for Payer: Healthfirst QHP	$18.37
Rate for Payer: Humana Medicare	$18.74
Rate for Payer: Senior Whole Health Medicare Advantage	$18.37
Rate for Payer: United Healthcare Commercial	$23.26
Rate for Payer: United Healthcare Medicare Advantage	$18.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$14.70
Rate for Payer: Wellcare Medicare	$16.53

HEPARIN INDUCED PLATELET

Facility

$45.93

Service Code	HCPCS 86022
Hospital Charge Code	40629227
Hospital Revenue Code	300
Rate for Payer: Cash Price	$18.37

HEPARIN LOCK FLUSH 100 UNITS/ML INJ 10 M

Facility

$1.33

Service Code	HCPCS J1642
Hospital Charge Code	41654804
Hospital Revenue Code	636
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67

HEPARIN LOCK FLUSH 100 UNITS/ML INJ 10 M

Facility

$1.33

Service Code	HCPCS J1642
Hospital Charge Code	41644804
Hospital Revenue Code	636
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.76
Rate for Payer: Group Health Inc Commercial	$0.67
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.02
Rate for Payer: SOMOS Essential	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.86

HEPARIN LOCK FLUSH 100 UNITS/ML INJ 10 M

Facility

$1.33

Service Code	HCPCS J1642
Hospital Charge Code	41644804
Hospital Revenue Code	636
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$0.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67

HEPARIN LOCK FLUSH 100 UNITS/ML INJ 10 M

Facility

$1.33

Service Code	HCPCS J1642
Hospital Charge Code	41654804
Hospital Revenue Code	636
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.76
Rate for Payer: Group Health Inc Commercial	$0.67
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.02
Rate for Payer: SOMOS Essential	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.86

HEPARIN LOCK FLUSH 100 UNITS/ML INJ 1 ML

Facility

$0.07

Service Code	HCPCS J1642
Hospital Charge Code	41654205
Hospital Revenue Code	636
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04

HEPARIN LOCK FLUSH 100 UNITS/ML INJ 1 ML

Facility

$0.07

Service Code	HCPCS J1642
Hospital Charge Code	41644205
Hospital Revenue Code	636
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.04
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.02
Rate for Payer: SOMOS Essential	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

HEPARIN LOCK FLUSH 100 UNITS/ML INJ 1 ML

Facility

$0.07

Service Code	HCPCS J1642
Hospital Charge Code	41644205
Hospital Revenue Code	636
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04

HEPARIN LOCK FLUSH 100 UNITS/ML INJ 1 ML

Facility

$0.07

Service Code	HCPCS J1642
Hospital Charge Code	41654205
Hospital Revenue Code	636
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.04
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.02
Rate for Payer: SOMOS Essential	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN [188986]

Facility

$0.74

Service Code	HCPCS J1642
Hospital Charge Code	64253033335
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.43
Rate for Payer: EmblemHealth Commercial	$0.37
Rate for Payer: Fidelis Medicare Advantage	$0.78
Rate for Payer: Group Health Inc Commercial	$0.37
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37
Rate for Payer: Hamaspik Choice Inc Medicare	$0.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.48

HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN [188986]

Facility

$0.17

Service Code	HCPCS J1642
Hospital Charge Code	08290306424
Hospital Revenue Code	278
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08
Rate for Payer: Hamaspik Choice Inc Medicare	$0.08

HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN [188986]

Facility

$0.74

Service Code	HCPCS J1642
Hospital Charge Code	64253033335
Hospital Revenue Code	278
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.37
Rate for Payer: Hamaspik Choice Inc Medicare	$0.37

HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN [188986]

Facility

$1.13

Service Code	HCPCS J1642
Hospital Charge Code	64253033333
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$1.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.65
Rate for Payer: EmblemHealth Commercial	$0.57
Rate for Payer: Fidelis Medicare Advantage	$1.19
Rate for Payer: Group Health Inc Commercial	$0.57
Rate for Payer: Group Health Inc Medicare	$0.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.57
Rate for Payer: Hamaspik Choice Inc Medicare	$0.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.73

HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN [188986]

Facility

$0.17

Service Code	HCPCS J1642
Hospital Charge Code	08290306424
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.08
Rate for Payer: Fidelis Medicare Advantage	$0.17
Rate for Payer: Group Health Inc Commercial	$0.08
Rate for Payer: Group Health Inc Medicare	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08
Rate for Payer: Hamaspik Choice Inc Medicare	$0.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.11

HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN [188986]

Facility

$1.13

Service Code	HCPCS J1642
Hospital Charge Code	64253033333
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$0.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.57
Rate for Payer: Hamaspik Choice Inc Medicare	$0.57

HEPARIN (PORCINE) IN NACL 1000-0.9 UT/500ML-% IV SOLN [166266]

Facility

$0.01

Service Code	HCPCS J1644
Hospital Charge Code	00264987210
Hospital Revenue Code	278
Max. Negotiated Rate	$0.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
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: Fidelis Medicare Advantage	$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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

Know your out-of-pocket cost for care.

All Charges