St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Cellulitis & other skin infections

Facility

$40,900.10

Service Code	APR-DRG 3831
Min. Negotiated Rate	$5,956.00
Max. Negotiated Rate	$40,900.10
Rate for Payer: Affinity Essential Plan 1&2	$40,900.10
Rate for Payer: Affinity Essential Plan 3&4	$40,900.10
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,177.82
Rate for Payer: Amida Care Medicaid	$18,177.82
Rate for Payer: EmblemHealth Essential Plan 1&2	$40,900.10
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,177.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,177.82
Rate for Payer: Fidelis Qualified Health Plan	$21,813.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,177.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,177.82
Rate for Payer: Healthfirst Commercial	$10,277.00
Rate for Payer: Healthfirst Essential Plan	$40,900.10
Rate for Payer: Healthfirst QHP	$5,956.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,177.82
Rate for Payer: SOMOS Essential	$40,900.10
Rate for Payer: United Healthcare Essential Plan 1&2	$40,900.10
Rate for Payer: United Healthcare Essential Plan 3&4	$40,900.10
Rate for Payer: United Healthcare Medicaid	$18,177.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,177.82

Cellulitis & other skin infections

Facility

$44,050.00

Service Code	APR-DRG 3832
Min. Negotiated Rate	$7,771.00
Max. Negotiated Rate	$44,050.00
Rate for Payer: Affinity Essential Plan 1&2	$44,050.00
Rate for Payer: Affinity Essential Plan 3&4	$44,050.00
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,577.78
Rate for Payer: Amida Care Medicaid	$19,577.78
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,050.00
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,577.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,577.78
Rate for Payer: Fidelis Qualified Health Plan	$23,493.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,577.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,577.78
Rate for Payer: Healthfirst Commercial	$13,299.00
Rate for Payer: Healthfirst Essential Plan	$44,050.00
Rate for Payer: Healthfirst QHP	$7,771.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,577.78
Rate for Payer: SOMOS Essential	$44,050.00
Rate for Payer: United Healthcare Essential Plan 1&2	$44,050.00
Rate for Payer: United Healthcare Essential Plan 3&4	$44,050.00
Rate for Payer: United Healthcare Medicaid	$19,577.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,577.78

CENTRUM PO LIQD

Facility

$0.03

Service Code	NDC 0005434362
Hospital Charge Code	0005434362
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: EmblemHealth Commercial	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

CENTRUM PO LIQD

Facility

$0.03

Service Code	NDC 0005434362
Hospital Charge Code	0005434362
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02

CEPHALEXIN 125 MG/5ML PO SUSR

Facility

$0.24

Service Code	NDC 0093417573
Hospital Charge Code	0093417573
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12

CEPHALEXIN 125 MG/5ML PO SUSR

Facility

$0.24

Service Code	NDC 0093417573
Hospital Charge Code	0093417573
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Brighton Health Commercial	$0.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: EmblemHealth Commercial	$0.12
Rate for Payer: Group Health Inc Commercial	$0.12
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12
Rate for Payer: Hamaspik Choice Inc Medicare	$0.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.15

CEPHALEXIN 125 MG/5ML PO SUSR

Facility

$0.24

Service Code	NDC 6787754488
Hospital Charge Code	6787754488
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12

CEPHALEXIN 125 MG/5ML PO SUSR

Facility

$0.24

Service Code	NDC 6787754488
Hospital Charge Code	6787754488
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Brighton Health Commercial	$0.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: EmblemHealth Commercial	$0.12
Rate for Payer: Group Health Inc Commercial	$0.12
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12
Rate for Payer: Hamaspik Choice Inc Medicare	$0.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.15

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.20

Service Code	NDC 6787754568
Hospital Charge Code	6787754568
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.29

Service Code	NDC 6818044101
Hospital Charge Code	6818044101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.29

Service Code	NDC 0093417773
Hospital Charge Code	0093417773
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.20

Service Code	NDC 6787754568
Hospital Charge Code	6787754568
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Brighton Health Commercial	$0.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: EmblemHealth Commercial	$0.10
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.13

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.29

Service Code	NDC 9999123404
Hospital Charge Code	9999123404
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.29

Service Code	NDC 9999123404
Hospital Charge Code	9999123404
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Brighton Health Commercial	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.19

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.23

Service Code	NDC 6787754588
Hospital Charge Code	6787754588
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.23

Service Code	NDC 6787754588
Hospital Charge Code	6787754588
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.11
Rate for Payer: Aetna Government	$0.11
Rate for Payer: Brighton Health Commercial	$0.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: EmblemHealth Commercial	$0.11
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11
Rate for Payer: Hamaspik Choice Inc Medicare	$0.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.15

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.29

Service Code	NDC 0093417773
Hospital Charge Code	0093417773
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Brighton Health Commercial	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.19

CEPHALEXIN 250 MG/5ML PO SUSR

Facility

$0.29

Service Code	NDC 6818044101
Hospital Charge Code	6818044101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Brighton Health Commercial	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.19

CEPHALEXIN 250 MG PO CAPS

Facility

$0.69

Service Code	NDC 6818012101
Hospital Charge Code	6818012101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.35

CEPHALEXIN 250 MG PO CAPS

Facility

$0.71

Service Code	NDC 6068715201
Hospital Charge Code	6068715201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36

CEPHALEXIN 250 MG PO CAPS

Facility

$0.71

Service Code	NDC 6068715201
Hospital Charge Code	6068715201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.36
Rate for Payer: Aetna Government	$0.36
Rate for Payer: Brighton Health Commercial	$0.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.48
Rate for Payer: EmblemHealth Commercial	$0.36
Rate for Payer: Group Health Inc Commercial	$0.36
Rate for Payer: Group Health Inc Medicare	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36
Rate for Payer: Hamaspik Choice Inc Medicare	$0.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.46

CEPHALEXIN 250 MG PO CAPS

Facility

$0.69

Service Code	NDC 6818012101
Hospital Charge Code	6818012101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.35
Rate for Payer: Aetna Government	$0.35
Rate for Payer: Brighton Health Commercial	$0.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.47
Rate for Payer: EmblemHealth Commercial	$0.35
Rate for Payer: Group Health Inc Commercial	$0.35
Rate for Payer: Group Health Inc Medicare	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.35
Rate for Payer: Hamaspik Choice Inc Medicare	$0.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.45

CEPHALEXIN 250 MG PO CAPS

Facility

$0.68

Service Code	NDC 5026815115
Hospital Charge Code	5026815115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34

CEPHALEXIN 250 MG PO CAPS

Facility

$0.68

Service Code	NDC 5026815115
Hospital Charge Code	5026815115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.34
Rate for Payer: Aetna Government	$0.34
Rate for Payer: Brighton Health Commercial	$0.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.46
Rate for Payer: EmblemHealth Commercial	$0.34
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.44

CEPHALEXIN 500 MG PO CAPS

Facility

$0.45

Service Code	NDC 0904733761
Hospital Charge Code	0904733761
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23

Know your out-of-pocket cost for care.

All Charges