St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

KIT FIBULOCK DISP

Facility

$3,000.00

Hospital Charge Code	64906942
Hospital Revenue Code	279
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,500.00
Rate for Payer: Aetna Government	$1,500.00
Rate for Payer: Brighton Health Commercial	$2,250.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,040.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

KIT FIBULOCK DISP (AR-8973DS)

Facility

$1,400.00

Hospital Charge Code	64906565
Hospital Revenue Code	270
Min. Negotiated Rate	$490.00
Max. Negotiated Rate	$1,120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$770.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$700.00
Rate for Payer: Aetna Government	$700.00
Rate for Payer: Brighton Health Commercial	$1,050.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$952.00
Rate for Payer: Group Health Inc Commercial	$700.00
Rate for Payer: Group Health Inc Medicare	$490.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$700.00

KIT, FILTER, PES MEMBRANE

Facility

$955.63

Hospital Charge Code	64903592
Hospital Revenue Code	270
Min. Negotiated Rate	$334.47
Max. Negotiated Rate	$764.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$525.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$477.82
Rate for Payer: Aetna Government	$477.82
Rate for Payer: Brighton Health Commercial	$716.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$764.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$649.83
Rate for Payer: Group Health Inc Commercial	$477.82
Rate for Payer: Group Health Inc Medicare	$334.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$477.82
Rate for Payer: Hamaspik Choice Inc Medicare	$477.82

KIT FL02 ADJ ER OXYGEN SYSTEM

Facility

$20.28

Hospital Charge Code	64902330
Hospital Revenue Code	270
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$16.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.14
Rate for Payer: Aetna Government	$10.14
Rate for Payer: Brighton Health Commercial	$15.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.79
Rate for Payer: Group Health Inc Commercial	$10.14
Rate for Payer: Group Health Inc Medicare	$7.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.14
Rate for Payer: Hamaspik Choice Inc Medicare	$10.14

KIT FLOSEAL HEMOSTATIC MATRIX

Facility

$460.10

Hospital Charge Code	64904710
Hospital Revenue Code	270
Min. Negotiated Rate	$161.04
Max. Negotiated Rate	$368.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$230.05
Rate for Payer: Aetna Government	$230.05
Rate for Payer: Brighton Health Commercial	$345.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$368.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$312.87
Rate for Payer: Group Health Inc Commercial	$230.05
Rate for Payer: Group Health Inc Medicare	$161.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.05
Rate for Payer: Hamaspik Choice Inc Medicare	$230.05

KIT FLOSEAL HEMOSTATIC MTRX 10ML

Facility

$841.78

Hospital Charge Code	64904908
Hospital Revenue Code	270
Min. Negotiated Rate	$294.62
Max. Negotiated Rate	$673.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$462.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$420.89
Rate for Payer: Aetna Government	$420.89
Rate for Payer: Brighton Health Commercial	$631.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$673.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$572.41
Rate for Payer: Group Health Inc Commercial	$420.89
Rate for Payer: Group Health Inc Medicare	$294.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$420.89
Rate for Payer: Hamaspik Choice Inc Medicare	$420.89

KIT HCG COMBO TEST PAK

Facility

$250.00

Hospital Charge Code	64902611
Hospital Revenue Code	270
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$137.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$125.00
Rate for Payer: Aetna Government	$125.00
Rate for Payer: Brighton Health Commercial	$187.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$170.00
Rate for Payer: Group Health Inc Commercial	$125.00
Rate for Payer: Group Health Inc Medicare	$87.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$125.00

KIT HEMO POWDER GEL 10ML

Facility

$300.00

Hospital Charge Code	64905056
Hospital Revenue Code	270
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$150.00
Rate for Payer: Aetna Government	$150.00
Rate for Payer: Brighton Health Commercial	$225.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$204.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

KIT INSTRUMENT STERILE 3.0MM

Facility

$766.00

Hospital Charge Code	64906251
Hospital Revenue Code	270
Min. Negotiated Rate	$268.10
Max. Negotiated Rate	$612.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$383.00
Rate for Payer: Aetna Government	$383.00
Rate for Payer: Brighton Health Commercial	$574.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$612.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$520.88
Rate for Payer: Group Health Inc Commercial	$383.00
Rate for Payer: Group Health Inc Medicare	$268.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.00
Rate for Payer: Hamaspik Choice Inc Medicare	$383.00

KIT INTRO CATH 9FR 13CML

Facility

$146.25

Hospital Charge Code	64902633
Hospital Revenue Code	279
Min. Negotiated Rate	$51.19
Max. Negotiated Rate	$117.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.12
Rate for Payer: Aetna Government	$73.12
Rate for Payer: Brighton Health Commercial	$109.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$117.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.45
Rate for Payer: Group Health Inc Commercial	$73.12
Rate for Payer: Group Health Inc Medicare	$51.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.12
Rate for Payer: Hamaspik Choice Inc Medicare	$73.12

KIT INTRODUCER LEAD

Facility

$700.00

Hospital Charge Code	64904936
Hospital Revenue Code	270
Min. Negotiated Rate	$245.00
Max. Negotiated Rate	$560.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$350.00
Rate for Payer: Aetna Government	$350.00
Rate for Payer: Brighton Health Commercial	$525.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$560.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$476.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

KIT INTRODUCER LEAD INTER

Facility

$679.00

Hospital Charge Code	64905543
Hospital Revenue Code	270
Min. Negotiated Rate	$237.65
Max. Negotiated Rate	$543.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$373.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.50
Rate for Payer: Aetna Government	$339.50
Rate for Payer: Brighton Health Commercial	$509.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$543.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$461.72
Rate for Payer: Group Health Inc Commercial	$339.50
Rate for Payer: Group Health Inc Medicare	$237.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$339.50
Rate for Payer: Hamaspik Choice Inc Medicare	$339.50

KIT INTRODUCER MICROPUNCTURE 6202

Facility

$62.00

Hospital Charge Code	64906776
Hospital Revenue Code	270
Min. Negotiated Rate	$21.70
Max. Negotiated Rate	$49.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.00
Rate for Payer: Aetna Government	$31.00
Rate for Payer: Brighton Health Commercial	$46.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$49.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.16
Rate for Payer: Group Health Inc Commercial	$31.00
Rate for Payer: Group Health Inc Medicare	$21.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.00
Rate for Payer: Hamaspik Choice Inc Medicare	$31.00

KIT INTRO LEAD CATH .035 18

Facility

$146.25

Hospital Charge Code	64902630
Hospital Revenue Code	279
Min. Negotiated Rate	$51.19
Max. Negotiated Rate	$117.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.12
Rate for Payer: Aetna Government	$73.12
Rate for Payer: Brighton Health Commercial	$109.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$117.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.45
Rate for Payer: Group Health Inc Commercial	$73.12
Rate for Payer: Group Health Inc Medicare	$51.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.12
Rate for Payer: Hamaspik Choice Inc Medicare	$73.12

KIT INTRO PERCUTANEOUS SHEATH

Facility

$77.15

Hospital Charge Code	64901687
Hospital Revenue Code	270
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$61.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$42.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$38.58
Rate for Payer: Aetna Government	$38.58
Rate for Payer: Brighton Health Commercial	$57.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$61.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$52.46
Rate for Payer: Group Health Inc Commercial	$38.58
Rate for Payer: Group Health Inc Medicare	$27.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.58
Rate for Payer: Hamaspik Choice Inc Medicare	$38.58

KIT INTRO PERCUTAN SHEATH 6FR

Facility

$72.58

Hospital Charge Code	64901498
Hospital Revenue Code	270
Min. Negotiated Rate	$25.40
Max. Negotiated Rate	$58.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$36.29
Rate for Payer: Aetna Government	$36.29
Rate for Payer: Brighton Health Commercial	$54.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.35
Rate for Payer: Group Health Inc Commercial	$36.29
Rate for Payer: Group Health Inc Medicare	$25.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.29
Rate for Payer: Hamaspik Choice Inc Medicare	$36.29

KIT ISOLATION A

Facility

$23.65

Hospital Charge Code	64901319
Hospital Revenue Code	270
Min. Negotiated Rate	$8.28
Max. Negotiated Rate	$18.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.82
Rate for Payer: Aetna Government	$11.82
Rate for Payer: Brighton Health Commercial	$17.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.08
Rate for Payer: Group Health Inc Commercial	$11.82
Rate for Payer: Group Health Inc Medicare	$8.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.82
Rate for Payer: Hamaspik Choice Inc Medicare	$11.82

KIT ISOLATION B

Facility

$23.65

Hospital Charge Code	64902189
Hospital Revenue Code	270
Min. Negotiated Rate	$8.28
Max. Negotiated Rate	$18.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.82
Rate for Payer: Aetna Government	$11.82
Rate for Payer: Brighton Health Commercial	$17.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.08
Rate for Payer: Group Health Inc Commercial	$11.82
Rate for Payer: Group Health Inc Medicare	$8.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.82
Rate for Payer: Hamaspik Choice Inc Medicare	$11.82

KIT IV START

Facility

$2.78

Hospital Charge Code	64901101
Hospital Revenue Code	270
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$2.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.39
Rate for Payer: Aetna Government	$1.39
Rate for Payer: Brighton Health Commercial	$2.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.89
Rate for Payer: Group Health Inc Commercial	$1.39
Rate for Payer: Group Health Inc Medicare	$0.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.39
Rate for Payer: Hamaspik Choice Inc Medicare	$1.39

KIT KNEE CPM PATIENT PAD

Facility

$42.80

Hospital Charge Code	64904993
Hospital Revenue Code	270
Min. Negotiated Rate	$14.98
Max. Negotiated Rate	$34.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.40
Rate for Payer: Aetna Government	$21.40
Rate for Payer: Brighton Health Commercial	$32.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.10
Rate for Payer: Group Health Inc Commercial	$21.40
Rate for Payer: Group Health Inc Medicare	$14.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.40
Rate for Payer: Hamaspik Choice Inc Medicare	$21.40

KIT LACERATION ER

Facility

$0.96

Hospital Charge Code	64901118
Hospital Revenue Code	270
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Brighton Health Commercial	$0.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.65
Rate for Payer: Group Health Inc Commercial	$0.48
Rate for Payer: Group Health Inc Medicare	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.48
Rate for Payer: Hamaspik Choice Inc Medicare	$0.48

KIT LAVAGE PERITONEAL

Facility

$54.58

Hospital Charge Code	64901243
Hospital Revenue Code	270
Min. Negotiated Rate	$19.10
Max. Negotiated Rate	$43.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.29
Rate for Payer: Aetna Government	$27.29
Rate for Payer: Brighton Health Commercial	$40.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.11
Rate for Payer: Group Health Inc Commercial	$27.29
Rate for Payer: Group Health Inc Medicare	$19.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.29
Rate for Payer: Hamaspik Choice Inc Medicare	$27.29

KIT LEAD SNS

Facility

$8,537.50

Hospital Charge Code	64904934
Hospital Revenue Code	270
Min. Negotiated Rate	$2,988.12
Max. Negotiated Rate	$6,830.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,695.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,268.75
Rate for Payer: Aetna Government	$4,268.75
Rate for Payer: Brighton Health Commercial	$6,403.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,830.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,805.50
Rate for Payer: Group Health Inc Commercial	$4,268.75
Rate for Payer: Group Health Inc Medicare	$2,988.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,268.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,268.75

KIT MAS 2 X 42-44 C-E WH

Facility

$74.88

Hospital Charge Code	64905849
Hospital Revenue Code	270
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$59.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.44
Rate for Payer: Aetna Government	$37.44
Rate for Payer: Brighton Health Commercial	$56.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$59.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.92
Rate for Payer: Group Health Inc Commercial	$37.44
Rate for Payer: Group Health Inc Medicare	$26.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.44
Rate for Payer: Hamaspik Choice Inc Medicare	$37.44

KIT MAS 3 X 46-48 E-I WH

Facility

$74.88

Hospital Charge Code	64905850
Hospital Revenue Code	270
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$59.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.44
Rate for Payer: Aetna Government	$37.44
Rate for Payer: Brighton Health Commercial	$56.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$59.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.92
Rate for Payer: Group Health Inc Commercial	$37.44
Rate for Payer: Group Health Inc Medicare	$26.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.44
Rate for Payer: Hamaspik Choice Inc Medicare	$37.44

Know your out-of-pocket cost for care.

All Charges