St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

INSULIN LISPRO INJECTION

Facility

$0.44

Hospital Charge Code	41657026
Hospital Revenue Code	636
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22

INSULIN LISPRO INJECTION

Facility

$0.44

Hospital Charge Code	41647026
Hospital Revenue Code	636
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.22
Rate for Payer: Aetna Government	$0.22
Rate for Payer: Brighton Health Commercial	$0.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.25
Rate for Payer: Group Health Inc Commercial	$0.22
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

INSULIN LISPRO INJECTION

Facility

$0.44

Hospital Charge Code	41647026
Hospital Revenue Code	636
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22

INSULIN LISPRO PROTAMINE/INSULIN

Facility

$10.00

Service Code	HCPCS J1815
Hospital Charge Code	41647000
Hospital Revenue Code	636
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$6.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$6.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.75
Rate for Payer: Group Health Inc Commercial	$5.00
Rate for Payer: Group Health Inc Medicare	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.50

INSULIN LISPRO PROTAMINE/INSULIN

Facility

$9.00

Service Code	HCPCS J1815
Hospital Charge Code	41646099
Hospital Revenue Code	636
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$5.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$5.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.18
Rate for Payer: Group Health Inc Commercial	$4.50
Rate for Payer: Group Health Inc Medicare	$3.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.85

INSULIN LISPRO PROTAMINE/INSULIN

Facility

$9.00

Service Code	HCPCS J1815
Hospital Charge Code	41656099
Hospital Revenue Code	636
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$5.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$5.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.18
Rate for Payer: Group Health Inc Commercial	$4.50
Rate for Payer: Group Health Inc Medicare	$3.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.85

INSULIN LISPRO PROTAMINE/INSULIN

Facility

$9.00

Service Code	HCPCS J1815
Hospital Charge Code	41646099
Hospital Revenue Code	636
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4.50

INSULIN LISPRO PROTAMINE/INSULIN

Facility

$10.00

Service Code	HCPCS J1815
Hospital Charge Code	41647000
Hospital Revenue Code	636
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00

INSULIN LISPRO PROTAMINE/INSULIN

Facility

$9.00

Service Code	HCPCS J1815
Hospital Charge Code	41656099
Hospital Revenue Code	636
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4.50

INSULIN LISPRO PROTAMINE/LISPRO

Facility

$10.00

Service Code	HCPCS J1815
Hospital Charge Code	41657000
Hospital Revenue Code	636
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$6.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$6.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.75
Rate for Payer: Group Health Inc Commercial	$5.00
Rate for Payer: Group Health Inc Medicare	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.50

INSULIN LISPRO PROTAMINE/LISPRO

Facility

$10.00

Service Code	HCPCS J1815
Hospital Charge Code	41657000
Hospital Revenue Code	636
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00

INSULIN LISPRO PROT & LISPRO (50-50) 100 UNIT/ML SC SUSP [70694]

Facility

$10.25

Service Code	HCPCS J1815
Hospital Charge Code	00002751201
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$8.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$7.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.97
Rate for Payer: Group Health Inc Commercial	$5.12
Rate for Payer: Group Health Inc Medicare	$3.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.12
Rate for Payer: Hamaspik Choice Inc Medicare	$5.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.66

INSULIN LISPRO PROT & LISPRO (75-25) 100 UNIT/ML SC SUSP [70693]

Facility

$10.25

Service Code	HCPCS J1815
Hospital Charge Code	00002751101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$8.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$7.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.97
Rate for Payer: Group Health Inc Commercial	$5.12
Rate for Payer: Group Health Inc Medicare	$3.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.12
Rate for Payer: Hamaspik Choice Inc Medicare	$5.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.66

INSULIN NPH 100 UNITS/ML INJ

Facility

$1.23

Service Code	HCPCS J1815
Hospital Charge Code	41640031
Hospital Revenue Code	636
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.62
Rate for Payer: Hamaspik Choice Inc Medicare	$0.62

INSULIN NPH 100 UNITS/ML INJ

Facility

$1.23

Service Code	HCPCS J1815
Hospital Charge Code	41650031
Hospital Revenue Code	636
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$0.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.71
Rate for Payer: Group Health Inc Commercial	$0.62
Rate for Payer: Group Health Inc Medicare	$0.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.62
Rate for Payer: Hamaspik Choice Inc Medicare	$0.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.80

INSULIN NPH 100 UNITS/ML INJ

Facility

$1.23

Service Code	HCPCS J1815
Hospital Charge Code	41640031
Hospital Revenue Code	636
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$0.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.71
Rate for Payer: Group Health Inc Commercial	$0.62
Rate for Payer: Group Health Inc Medicare	$0.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.62
Rate for Payer: Hamaspik Choice Inc Medicare	$0.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.80

INSULIN NPH 100 UNITS/ML INJ

Facility

$1.23

Service Code	HCPCS J1815
Hospital Charge Code	41650031
Hospital Revenue Code	636
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.62
Rate for Payer: Hamaspik Choice Inc Medicare	$0.62

INSULIN NPH (HUMAN) (ISOPHANE) 100 UNIT/ML SC SUSP [10284]

Facility

$17.84

Service Code	HCPCS J1815
Hospital Charge Code	00002831517
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$14.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$13.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.13
Rate for Payer: Group Health Inc Commercial	$8.92
Rate for Payer: Group Health Inc Medicare	$6.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.92
Rate for Payer: Hamaspik Choice Inc Medicare	$8.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.60

INSULIN NPH (HUMAN) (ISOPHANE) 100 UNIT/ML SC SUSP [10284]

Facility

$5.35

Service Code	HCPCS J1815
Hospital Charge Code	00002831501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$4.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$4.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.64
Rate for Payer: Group Health Inc Commercial	$2.68
Rate for Payer: Group Health Inc Medicare	$1.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.68
Rate for Payer: Hamaspik Choice Inc Medicare	$2.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.48

INSULIN NPH (HUMAN) (ISOPHANE) 100 UNIT/ML SC SUSP [10284]

Facility

$5.78

Service Code	HCPCS J1815
Hospital Charge Code	00169183411
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$4.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$4.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.93
Rate for Payer: Group Health Inc Commercial	$2.89
Rate for Payer: Group Health Inc Medicare	$2.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.89
Rate for Payer: Hamaspik Choice Inc Medicare	$2.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.76

INSULIN NPH HUMAN RECOMB 100U/3ML

Facility

$2.11

Service Code	HCPCS J1815
Hospital Charge Code	41648449
Hospital Revenue Code	636
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1.06

INSULIN NPH HUMAN RECOMB 100U/3ML

Facility

$2.11

Service Code	HCPCS J1815
Hospital Charge Code	41658449
Hospital Revenue Code	636
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1.06

INSULIN NPH HUMAN RECOMB 100U/3ML

Facility

$2.11

Service Code	HCPCS J1815
Hospital Charge Code	41648449
Hospital Revenue Code	636
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$1.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.21
Rate for Payer: Group Health Inc Commercial	$1.06
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.37

INSULIN NPH HUMAN RECOMB 100U/3ML

Facility

$2.11

Service Code	HCPCS J1815
Hospital Charge Code	41658449
Hospital Revenue Code	636
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$1.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.21
Rate for Payer: Group Health Inc Commercial	$1.06
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.37

INSULIN REG HUMAN RECOMB 100U/3ML

Facility

$1.83

Service Code	HCPCS J1815
Hospital Charge Code	41658450
Hospital Revenue Code	636
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$1.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$1.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.05
Rate for Payer: Group Health Inc Commercial	$0.92
Rate for Payer: Group Health Inc Medicare	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.92
Rate for Payer: Hamaspik Choice Inc Medicare	$0.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.19

Know your out-of-pocket cost for care.

All Charges