St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

INST UNIV BONE REP 3.2MM

Facility

$1,157.33

Service Code	HCPCS C1713
Hospital Charge Code	64901555
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,215.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$636.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$694.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$578.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$665.46
Rate for Payer: EmblemHealth Commercial	$578.66
Rate for Payer: Fidelis Medicare Advantage	$1,215.20
Rate for Payer: Group Health Inc Commercial	$578.66
Rate for Payer: Group Health Inc Medicare	$405.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.66
Rate for Payer: Hamaspik Choice Inc Medicare	$578.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$752.26

INSULIN_

Facility

$28.58

Service Code	HCPCS 83525
Hospital Charge Code	40609094
Hospital Revenue Code	300
Rate for Payer: Cash Price	$11.43

INSULIN_

Facility

$28.58

Service Code	HCPCS 83525
Hospital Charge Code	40609094
Hospital Revenue Code	300
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$21.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.43
Rate for Payer: Aetna Government	$11.43
Rate for Payer: Affinity Essential Plan 1&2	$8.00
Rate for Payer: Affinity Essential Plan 3&4	$8.00
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.00
Rate for Payer: Brighton Health Commercial	$21.44
Rate for Payer: Cash Price	$11.43
Rate for Payer: Cash Price	$11.43
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$11.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.38
Rate for Payer: Elderplan Medicare Advantage	$11.43
Rate for Payer: EmblemHealth Commercial	$11.43
Rate for Payer: Fidelis Essential Plan Aliesa	$9.72
Rate for Payer: Fidelis Essential Plan QHP	$10.17
Rate for Payer: Fidelis Medicare Advantage	$11.43
Rate for Payer: Fidelis Qualified Health Plan	$10.17
Rate for Payer: Group Health Inc Commercial	$11.43
Rate for Payer: Group Health Inc Medicare	$11.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.29
Rate for Payer: Hamaspik Choice Inc Medicare	$11.43
Rate for Payer: Healthfirst Medicare Advantage	$11.43
Rate for Payer: Healthfirst QHP	$11.43
Rate for Payer: Humana Medicare	$11.66
Rate for Payer: Senior Whole Health Medicare Advantage	$11.43
Rate for Payer: United Healthcare Commercial	$14.48
Rate for Payer: United Healthcare Medicare Advantage	$11.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.43
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9.14
Rate for Payer: Wellcare Medicare	$10.29

INSULIN ANTIBODIES

Facility

$53.53

Service Code	HCPCS 86337
Hospital Charge Code	40729341
Hospital Revenue Code	300
Rate for Payer: Cash Price	$21.41

INSULIN ANTIBODIES

Facility

$53.53

Service Code	HCPCS 86337
Hospital Charge Code	40729341
Hospital Revenue Code	300
Min. Negotiated Rate	$14.99
Max. Negotiated Rate	$40.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.41
Rate for Payer: Aetna Government	$21.41
Rate for Payer: Affinity Essential Plan 1&2	$14.99
Rate for Payer: Affinity Essential Plan 3&4	$14.99
Rate for Payer: Affinity Medicaid/CHP/HARP	$14.99
Rate for Payer: Brighton Health Commercial	$40.15
Rate for Payer: Cash Price	$21.41
Rate for Payer: Cash Price	$21.41
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$21.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.80
Rate for Payer: Elderplan Medicare Advantage	$21.41
Rate for Payer: EmblemHealth Commercial	$21.41
Rate for Payer: Fidelis Essential Plan Aliesa	$18.20
Rate for Payer: Fidelis Essential Plan QHP	$19.05
Rate for Payer: Fidelis Medicare Advantage	$21.41
Rate for Payer: Fidelis Qualified Health Plan	$19.05
Rate for Payer: Group Health Inc Commercial	$21.41
Rate for Payer: Group Health Inc Medicare	$21.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$21.41
Rate for Payer: Healthfirst Medicare Advantage	$21.41
Rate for Payer: Healthfirst QHP	$21.41
Rate for Payer: Humana Medicare	$21.84
Rate for Payer: Senior Whole Health Medicare Advantage	$21.41
Rate for Payer: United Healthcare Commercial	$27.12
Rate for Payer: United Healthcare Medicare Advantage	$21.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.41
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17.13
Rate for Payer: Wellcare Medicare	$19.27

INSULIN ASPART 100 UNIT/ML IJ SOLN [183769]

Facility

$8.68

Service Code	NDC 00169750111
Hospital Charge Code	00169750111
Hospital Revenue Code	250
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$6.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.34
Rate for Payer: Aetna Government	$4.34
Rate for Payer: Brighton Health Commercial	$6.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.90
Rate for Payer: Group Health Inc Commercial	$4.34
Rate for Payer: Group Health Inc Medicare	$3.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.34
Rate for Payer: Hamaspik Choice Inc Medicare	$4.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.64

INSULIN ASPART 10ML - 5U

Facility

$0.10

Service Code	HCPCS J1815
Hospital Charge Code	41658145
Hospital Revenue Code	636
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05

INSULIN ASPART 10ML - 5U

Facility

$0.10

Service Code	HCPCS J1815
Hospital Charge Code	41658145
Hospital Revenue Code	636
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

INSULIN ASPART 10ML - 5U

Facility

$0.10

Service Code	HCPCS J1815
Hospital Charge Code	41648145
Hospital Revenue Code	636
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05

INSULIN ASPART 10ML - 5U

Facility

$0.10

Service Code	HCPCS J1815
Hospital Charge Code	41648145
Hospital Revenue Code	636
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

INSULIN AUTOANTIBODY

Facility

$53.53

Service Code	HCPCS 86337
Hospital Charge Code	30303374
Hospital Revenue Code	302
Rate for Payer: Cash Price	$21.41

INSULIN AUTOANTIBODY

Facility

$53.53

Service Code	HCPCS 86337
Hospital Charge Code	30303374
Hospital Revenue Code	302
Min. Negotiated Rate	$14.99
Max. Negotiated Rate	$40.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.41
Rate for Payer: Aetna Government	$21.41
Rate for Payer: Affinity Essential Plan 1&2	$14.99
Rate for Payer: Affinity Essential Plan 3&4	$14.99
Rate for Payer: Affinity Medicaid/CHP/HARP	$14.99
Rate for Payer: Brighton Health Commercial	$40.15
Rate for Payer: Cash Price	$21.41
Rate for Payer: Cash Price	$21.41
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$21.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.80
Rate for Payer: Elderplan Medicare Advantage	$21.41
Rate for Payer: EmblemHealth Commercial	$21.41
Rate for Payer: Fidelis Essential Plan Aliesa	$18.20
Rate for Payer: Fidelis Essential Plan QHP	$19.05
Rate for Payer: Fidelis Medicare Advantage	$21.41
Rate for Payer: Fidelis Qualified Health Plan	$19.05
Rate for Payer: Group Health Inc Commercial	$21.41
Rate for Payer: Group Health Inc Medicare	$21.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$21.41
Rate for Payer: Healthfirst Medicare Advantage	$21.41
Rate for Payer: Healthfirst QHP	$21.41
Rate for Payer: Humana Medicare	$21.84
Rate for Payer: Senior Whole Health Medicare Advantage	$21.41
Rate for Payer: United Healthcare Commercial	$27.12
Rate for Payer: United Healthcare Medicare Advantage	$21.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.41
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17.13
Rate for Payer: Wellcare Medicare	$19.27

INSULIN GLARGINE 100 UNIT/ML SC SOLN [28282]

Facility

$7.71

Service Code	HCPCS J1815
Hospital Charge Code	00088222033
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$6.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$5.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.24
Rate for Payer: Group Health Inc Commercial	$3.86
Rate for Payer: Group Health Inc Medicare	$2.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.86
Rate for Payer: Hamaspik Choice Inc Medicare	$3.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.01

INSULIN GLARGINE 100 UNITS/ML INJ

Facility

$1.54

Service Code	HCPCS J1815
Hospital Charge Code	41652804
Hospital Revenue Code	636
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$1.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$0.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.89
Rate for Payer: Group Health Inc Commercial	$0.77
Rate for Payer: Group Health Inc Medicare	$0.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.77
Rate for Payer: Hamaspik Choice Inc Medicare	$0.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.00

INSULIN GLARGINE 100 UNITS/ML INJ

Facility

$1.54

Service Code	HCPCS J1815
Hospital Charge Code	41642804
Hospital Revenue Code	636
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.77
Rate for Payer: Hamaspik Choice Inc Medicare	$0.77

INSULIN GLARGINE 100 UNITS/ML INJ

Facility

$1.54

Service Code	HCPCS J1815
Hospital Charge Code	41652804
Hospital Revenue Code	636
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.77
Rate for Payer: Hamaspik Choice Inc Medicare	$0.77

INSULIN GLARGINE 100 UNITS/ML INJ

Facility

$1.54

Service Code	HCPCS J1815
Hospital Charge Code	41642804
Hospital Revenue Code	636
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$1.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$0.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.89
Rate for Payer: Group Health Inc Commercial	$0.77
Rate for Payer: Group Health Inc Medicare	$0.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.77
Rate for Payer: Hamaspik Choice Inc Medicare	$0.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.00

INSULIN GLULISINE 100 UNIT/ML IJ SOLN [87889]

Facility

$10.22

Service Code	NDC 00088250033
Hospital Charge Code	00088250033
Hospital Revenue Code	250
Min. Negotiated Rate	$3.58
Max. Negotiated Rate	$8.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.11
Rate for Payer: Aetna Government	$5.11
Rate for Payer: Brighton Health Commercial	$7.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.95
Rate for Payer: Group Health Inc Commercial	$5.11
Rate for Payer: Group Health Inc Medicare	$3.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.11
Rate for Payer: Hamaspik Choice Inc Medicare	$5.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.64

INSULIN GLULISINE 10ML - 50U

Facility

$13.67

Service Code	HCPCS J1817
Hospital Charge Code	41648143
Hospital Revenue Code	636
Min. Negotiated Rate	$4.78
Max. Negotiated Rate	$11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.14
Rate for Payer: Aetna Government	$11.14
Rate for Payer: Brighton Health Commercial	$8.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.86
Rate for Payer: Group Health Inc Commercial	$6.84
Rate for Payer: Group Health Inc Medicare	$4.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.84
Rate for Payer: Hamaspik Choice Inc Medicare	$6.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.01
Rate for Payer: SOMOS Essential	$8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.89

INSULIN GLULISINE 10ML - 50U

Facility

$13.67

Service Code	HCPCS J1817
Hospital Charge Code	41648143
Hospital Revenue Code	636
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$6.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.84
Rate for Payer: Hamaspik Choice Inc Medicare	$6.84

INSULIN GLULISINE 10ML-50U

Facility

$13.67

Service Code	HCPCS J1817
Hospital Charge Code	41658143
Hospital Revenue Code	636
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$6.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.84
Rate for Payer: Hamaspik Choice Inc Medicare	$6.84

INSULIN GLULISINE 10ML-50U

Facility

$13.67

Service Code	HCPCS J1817
Hospital Charge Code	41658143
Hospital Revenue Code	636
Min. Negotiated Rate	$4.78
Max. Negotiated Rate	$11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.14
Rate for Payer: Aetna Government	$11.14
Rate for Payer: Brighton Health Commercial	$8.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.86
Rate for Payer: Group Health Inc Commercial	$6.84
Rate for Payer: Group Health Inc Medicare	$4.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.84
Rate for Payer: Hamaspik Choice Inc Medicare	$6.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.01
Rate for Payer: SOMOS Essential	$8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.89

INSULIN INF PUMP ASPART SBH DRUG

Facility

$7.73

Service Code	HCPCS J1817
Hospital Charge Code	41658195
Hospital Revenue Code	636
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.14
Rate for Payer: Aetna Government	$11.14
Rate for Payer: Brighton Health Commercial	$4.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.44
Rate for Payer: Group Health Inc Commercial	$3.86
Rate for Payer: Group Health Inc Medicare	$2.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.86
Rate for Payer: Hamaspik Choice Inc Medicare	$3.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.01
Rate for Payer: SOMOS Essential	$8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.02

INSULIN INF PUMP ASPART SBH DRUG

Facility

$7.73

Service Code	HCPCS J1817
Hospital Charge Code	41658195
Hospital Revenue Code	636
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$3.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.86
Rate for Payer: Hamaspik Choice Inc Medicare	$3.86

INSULIN INF PUMP ASPART SBH DRUG

Facility

$7.73

Service Code	HCPCS J1817
Hospital Charge Code	41648195
Hospital Revenue Code	636
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$3.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.86
Rate for Payer: Hamaspik Choice Inc Medicare	$3.86

Know your out-of-pocket cost for care.

All Charges