St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

INSULIN REG HUMAN RECOMB 100U/3ML

Facility

$1.83

Service Code	HCPCS J1815
Hospital Charge Code	41648450
Hospital Revenue Code	636
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.92
Rate for Payer: Hamaspik Choice Inc Medicare	$0.92

INSULIN REG HUMAN RECOMB 100U/3ML

Facility

$1.83

Service Code	HCPCS J1815
Hospital Charge Code	41658450
Hospital Revenue Code	636
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.92
Rate for Payer: Hamaspik Choice Inc Medicare	$0.92

INSULIN REG HUMAN RECOMB 100U/3ML

Facility

$1.83

Service Code	HCPCS J1815
Hospital Charge Code	41648450
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

INSULIN REGULAR 100 UNITS/ML INJ

Facility

$1.97

Service Code	HCPCS J1815
Hospital Charge Code	41653241
Hospital Revenue Code	636
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.99
Rate for Payer: Hamaspik Choice Inc Medicare	$0.99

INSULIN REGULAR 100 UNITS/ML INJ

Facility

$1.97

Service Code	HCPCS J1815
Hospital Charge Code	41643241
Hospital Revenue Code	636
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.99
Rate for Payer: Hamaspik Choice Inc Medicare	$0.99

INSULIN REGULAR 100 UNITS/ML INJ

Facility

$1.97

Service Code	HCPCS J1815
Hospital Charge Code	41653241
Hospital Revenue Code	636
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$1.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$1.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.13
Rate for Payer: Group Health Inc Commercial	$0.99
Rate for Payer: Group Health Inc Medicare	$0.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.99
Rate for Payer: Hamaspik Choice Inc Medicare	$0.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.28

INSULIN REGULAR 100 UNITS/ML INJ

Facility

$1.97

Service Code	HCPCS J1815
Hospital Charge Code	41643241
Hospital Revenue Code	636
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$1.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$1.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.13
Rate for Payer: Group Health Inc Commercial	$0.99
Rate for Payer: Group Health Inc Medicare	$0.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.99
Rate for Payer: Hamaspik Choice Inc Medicare	$0.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.28

INSULIN REGULAR 100UNITS/NS 100ML

Facility

$1.57

Service Code	HCPCS J1815
Hospital Charge Code	41646594
Hospital Revenue Code	636
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$1.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$0.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.90
Rate for Payer: Group Health Inc Commercial	$0.79
Rate for Payer: Group Health Inc Medicare	$0.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.79
Rate for Payer: Hamaspik Choice Inc Medicare	$0.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.02

INSULIN REGULAR 100UNITS/NS 100ML

Facility

$1.57

Service Code	HCPCS J1815
Hospital Charge Code	41646594
Hospital Revenue Code	636
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.79
Rate for Payer: Hamaspik Choice Inc Medicare	$0.79

INSULIN REGULAR 100UNITS/NS 100ML

Facility

$1.57

Service Code	HCPCS J1815
Hospital Charge Code	41656594
Hospital Revenue Code	636
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$0.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.79
Rate for Payer: Hamaspik Choice Inc Medicare	$0.79

INSULIN REGULAR 100UNITS/NS 100ML

Facility

$1.57

Service Code	HCPCS J1815
Hospital Charge Code	41656594
Hospital Revenue Code	636
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$1.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$0.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.90
Rate for Payer: Group Health Inc Commercial	$0.79
Rate for Payer: Group Health Inc Medicare	$0.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.79
Rate for Payer: Hamaspik Choice Inc Medicare	$0.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.02

INSULIN REGULAR 1 UNIT/ML INJ NEONATAL

Facility

$3.00

Hospital Charge Code	41644876
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

INSULIN REGULAR 1 UNIT/ML INJ NEONATAL

Facility

$3.00

Hospital Charge Code	41654876
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

INSULIN REGULAR 500 UNITS/ML INJ

Facility

$24.00

Service Code	HCPCS J1817
Hospital Charge Code	41644889
Hospital Revenue Code	636
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12.00

INSULIN REGULAR 500 UNITS/ML INJ

Facility

$24.00

Service Code	HCPCS J1817
Hospital Charge Code	41654889
Hospital Revenue Code	636
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12.00

INSULIN REGULAR 500 UNITS/ML INJ

Facility

$24.00

Service Code	HCPCS J1817
Hospital Charge Code	41644889
Hospital Revenue Code	636
Min. Negotiated Rate	$8.01
Max. Negotiated Rate	$15.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.14
Rate for Payer: Aetna Government	$11.14
Rate for Payer: Brighton Health Commercial	$14.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.80
Rate for Payer: Group Health Inc Commercial	$12.00
Rate for Payer: Group Health Inc Medicare	$8.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12.00
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	$15.60

INSULIN REGULAR 500 UNITS/ML INJ

Facility

$24.00

Service Code	HCPCS J1817
Hospital Charge Code	41654889
Hospital Revenue Code	636
Min. Negotiated Rate	$8.01
Max. Negotiated Rate	$15.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.14
Rate for Payer: Aetna Government	$11.14
Rate for Payer: Brighton Health Commercial	$14.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.80
Rate for Payer: Group Health Inc Commercial	$12.00
Rate for Payer: Group Health Inc Medicare	$8.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12.00
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	$15.60

INSULIN REGULAR HUMAN 100 UNIT/ML IJ SOLN [10289]

Facility

$5.78

Service Code	HCPCS J1815
Hospital Charge Code	00169183311
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 REGULAR HUMAN 100 UNIT/ML IJ SOLN [10289]

Facility

$5.35

Service Code	HCPCS J1815
Hospital Charge Code	00002021301
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 REGULAR HUMAN 100 UNIT/ML IJ SOLN [10289]

Facility

$5.35

Service Code	HCPCS J1815
Hospital Charge Code	00002821501
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 REGULAR HUMAN (CONC) 500 UNIT/ML SC SOLN [19180]

Facility

$89.22

Service Code	HCPCS J1815
Hospital Charge Code	00002850101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$71.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.95
Rate for Payer: Aetna Government	$0.95
Rate for Payer: Brighton Health Commercial	$66.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.67
Rate for Payer: Group Health Inc Commercial	$44.61
Rate for Payer: Group Health Inc Medicare	$31.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.61
Rate for Payer: Hamaspik Choice Inc Medicare	$44.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$57.99

INSULIN REGULAR(HUMAN) INFUSION PROTOCOL CALCULATOR (PREMIX) [401337]

Facility

$0.42

Service Code	NDC 00338012612
Hospital Charge Code	00338012612
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.21
Rate for Payer: Aetna Government	$0.21
Rate for Payer: Brighton Health Commercial	$0.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.29
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.27

INSULIN REGULAR(HUMAN) IN NACL 100-0.9 UT/100ML-% IV SOLN [168938]

Facility

$0.42

Service Code	NDC 00338012612
Hospital Charge Code	00338012612
Hospital Revenue Code	278
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.21
Rate for Payer: Aetna Government	$0.21
Rate for Payer: Brighton Health Commercial	$0.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
Rate for Payer: EmblemHealth Commercial	$0.21
Rate for Payer: Fidelis Medicare Advantage	$0.44
Rate for Payer: Group Health Inc Commercial	$0.21
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.27

INSULIN REGULAR(HUMAN) IN NACL 100-0.9 UT/100ML-% IV SOLN [168938]

Facility

$0.42

Service Code	NDC 00338012612
Hospital Charge Code	00338012612
Hospital Revenue Code	278
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.21
Rate for Payer: Hamaspik Choice Inc Medicare	$0.21

INTEGRA PMOCAB CABLE PROBE

Facility

$916.00

Hospital Charge Code	40205296
Hospital Revenue Code	270
Min. Negotiated Rate	$320.60
Max. Negotiated Rate	$732.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$503.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$458.00
Rate for Payer: Aetna Government	$458.00
Rate for Payer: Brighton Health Commercial	$687.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$732.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$622.88
Rate for Payer: Group Health Inc Commercial	$458.00
Rate for Payer: Group Health Inc Medicare	$320.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$458.00
Rate for Payer: Hamaspik Choice Inc Medicare	$458.00

Know your out-of-pocket cost for care.

All Charges