St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

INJ MED JOINT

Facility

$786.00

Service Code	HCPCS 20605
Hospital Charge Code	30305006
Hospital Revenue Code	510
Rate for Payer: Cash Price	$342.51

INJ MED JOINT

Facility

$786.00

Service Code	HCPCS 20605
Hospital Charge Code	30305006
Hospital Revenue Code	510
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$342.51
Rate for Payer: Aetna Government	$342.51
Rate for Payer: Affinity Essential Plan 1&2	$239.76
Rate for Payer: Affinity Essential Plan 3&4	$239.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$239.76
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$342.51
Rate for Payer: Cash Price	$342.51
Rate for Payer: Cash Price	$342.51
Rate for Payer: Cash Price	$342.51
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$342.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$342.51
Rate for Payer: Fidelis Essential Plan Aliesa	$291.13
Rate for Payer: Fidelis Essential Plan QHP	$304.83
Rate for Payer: Fidelis Medicare Advantage	$342.51
Rate for Payer: Fidelis Qualified Health Plan	$304.83
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$393.00
Rate for Payer: Hamaspik Choice Inc Medicare	$342.51
Rate for Payer: Healthfirst Medicare Advantage	$291.13
Rate for Payer: Healthfirst QHP	$342.51
Rate for Payer: Humana Medicare	$349.36
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$342.51
Rate for Payer: Senior Whole Health Medicare Advantage	$342.51
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$342.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$342.51
Rate for Payer: Wellcare CHP/FHP/Medicaid	$274.01
Rate for Payer: Wellcare Medicare	$325.38

INJ, METOCLOPRAMIDE HCL TO 10MG

Facility

$5.00

Service Code	HCPCS J2765
Hospital Charge Code	41657115
Hospital Revenue Code	636
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$3.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
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	$1.10
Rate for Payer: SOMOS Essential	$1.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

INJ, METOCLOPRAMIDE HCL TO 10MG

Facility

$5.00

Service Code	HCPCS J2765
Hospital Charge Code	41657115
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

INJ, METOCLOPRAMIDE TO 10 MG

Facility

$5.00

Service Code	HCPCS J2765
Hospital Charge Code	41647115
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

INJ, METOCLOPRAMIDE TO 10 MG

Facility

$5.00

Service Code	HCPCS J2765
Hospital Charge Code	41647115
Hospital Revenue Code	636
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$3.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.13
Rate for Payer: Aetna Government	$1.13
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	$1.10
Rate for Payer: SOMOS Essential	$1.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

INJ MORPHINE PRESERV FREE, 10MG

Facility

$43.00

Service Code	HCPCS J2274
Hospital Charge Code	41642671
Hospital Revenue Code	636
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$27.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$25.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.72
Rate for Payer: Group Health Inc Commercial	$21.50
Rate for Payer: Group Health Inc Medicare	$15.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.50
Rate for Payer: Hamaspik Choice Inc Medicare	$21.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$27.95

INJ MORPHINE PRESERV FREE, 10MG

Facility

$3.00

Service Code	HCPCS J2274
Hospital Charge Code	41647077
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$15.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

INJ MORPHINE PRESERV FREE, 10MG

Facility

$253.00

Service Code	HCPCS J2274
Hospital Charge Code	41654966
Hospital Revenue Code	636
Min. Negotiated Rate	$126.50
Max. Negotiated Rate	$126.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.50
Rate for Payer: Hamaspik Choice Inc Medicare	$126.50

INJ MORPHINE PRESERV FREE, 10MG

Facility

$3.00

Service Code	HCPCS J2274
Hospital Charge Code	41657077
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

INJ MORPHINE PRESERV FREE, 10MG

Facility

$43.00

Service Code	HCPCS J2274
Hospital Charge Code	41642671
Hospital Revenue Code	636
Min. Negotiated Rate	$21.50
Max. Negotiated Rate	$21.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.50
Rate for Payer: Hamaspik Choice Inc Medicare	$21.50

INJ MORPHINE PRESERV FREE, 10MG

Facility

$14.31

Service Code	HCPCS J2274
Hospital Charge Code	41647074
Hospital Revenue Code	636
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$15.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$8.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.23
Rate for Payer: Group Health Inc Commercial	$7.16
Rate for Payer: Group Health Inc Medicare	$5.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.16
Rate for Payer: Hamaspik Choice Inc Medicare	$7.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.30

INJ MORPHINE PRESERV FREE, 10MG

Facility

$3.00

Service Code	HCPCS J2274
Hospital Charge Code	41647077
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

INJ MORPHINE PRESERV FREE, 10MG

Facility

$43.00

Service Code	HCPCS J2274
Hospital Charge Code	41652671
Hospital Revenue Code	636
Min. Negotiated Rate	$21.50
Max. Negotiated Rate	$21.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.50
Rate for Payer: Hamaspik Choice Inc Medicare	$21.50

INJ MORPHINE PRESERV FREE, 10MG

Facility

$22.00

Service Code	HCPCS J2274
Hospital Charge Code	41653567
Hospital Revenue Code	636
Min. Negotiated Rate	$11.00
Max. Negotiated Rate	$11.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11.00

INJ MORPHINE PRESERV FREE, 10MG

Facility

$43.00

Service Code	HCPCS J2274
Hospital Charge Code	41652671
Hospital Revenue Code	636
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$27.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$25.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.72
Rate for Payer: Group Health Inc Commercial	$21.50
Rate for Payer: Group Health Inc Medicare	$15.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.50
Rate for Payer: Hamaspik Choice Inc Medicare	$21.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$27.95

INJ MORPHINE PRESERV FREE, 10MG

Facility

$0.08

Service Code	HCPCS J2274
Hospital Charge Code	41655450
Hospital Revenue Code	636
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$15.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
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	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

INJ MORPHINE PRESERV FREE, 10MG

Facility

$0.50

Service Code	HCPCS J2274
Hospital Charge Code	41658456
Hospital Revenue Code	636
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$15.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$0.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.29
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.18
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	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.33

INJ MORPHINE PRESERV FREE, 10MG

Facility

$21.00

Service Code	HCPCS J2274
Hospital Charge Code	41646025
Hospital Revenue Code	636
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$15.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$12.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.08
Rate for Payer: Group Health Inc Commercial	$10.50
Rate for Payer: Group Health Inc Medicare	$7.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.50
Rate for Payer: Hamaspik Choice Inc Medicare	$10.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.65

INJ MORPHINE PRESERV FREE, 10MG

Facility

$15.40

Service Code	HCPCS J2274
Hospital Charge Code	41645586
Hospital Revenue Code	636
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$7.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.70
Rate for Payer: Hamaspik Choice Inc Medicare	$7.70

INJ MORPHINE PRESERV FREE, 10MG

Facility

$22.00

Service Code	HCPCS J2274
Hospital Charge Code	41643567
Hospital Revenue Code	636
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$15.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$13.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.65
Rate for Payer: Group Health Inc Commercial	$11.00
Rate for Payer: Group Health Inc Medicare	$7.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.30

INJ MORPHINE PRESERV FREE, 10MG

Facility

$15.40

Service Code	HCPCS J2274
Hospital Charge Code	41645586
Hospital Revenue Code	636
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$15.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$9.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.86
Rate for Payer: Group Health Inc Commercial	$7.70
Rate for Payer: Group Health Inc Medicare	$5.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.70
Rate for Payer: Hamaspik Choice Inc Medicare	$7.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.01

INJ MORPHINE PRESERV FREE, 10MG

Facility

$21.00

Service Code	HCPCS J2274
Hospital Charge Code	41646025
Hospital Revenue Code	636
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.50
Rate for Payer: Hamaspik Choice Inc Medicare	$10.50

INJ MORPHINE PRESERV FREE, 10MG

Facility

$15.40

Service Code	HCPCS J2274
Hospital Charge Code	41655586
Hospital Revenue Code	636
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$15.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.08
Rate for Payer: Aetna Government	$11.08
Rate for Payer: Brighton Health Commercial	$9.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.86
Rate for Payer: Group Health Inc Commercial	$7.70
Rate for Payer: Group Health Inc Medicare	$5.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.70
Rate for Payer: Hamaspik Choice Inc Medicare	$7.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15.30
Rate for Payer: SOMOS Essential	$15.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.01

INJ MORPHINE PRESERV FREE, 10MG

Facility

$15.40

Service Code	HCPCS J2274
Hospital Charge Code	41655586
Hospital Revenue Code	636
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$7.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.70
Rate for Payer: Hamaspik Choice Inc Medicare	$7.70

Know your out-of-pocket cost for care.

All Charges