St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

KIT SHROUD PEDS

Facility

$3.40

Hospital Charge Code	64902429
Hospital Revenue Code	270
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$2.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$2.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.31
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70

KIT SIZING 500 MICROLITER

Facility

$600.00

Hospital Charge Code	64906892
Hospital Revenue Code	270
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$480.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$300.00
Rate for Payer: Aetna Government	$300.00
Rate for Payer: Brighton Health Commercial	$450.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$480.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$408.00
Rate for Payer: Group Health Inc Commercial	$300.00
Rate for Payer: Group Health Inc Medicare	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00

KIT SPINAL EPIDURAL 18GX3-1/2

Facility

$372.00

Hospital Charge Code	40200971
Hospital Revenue Code	270
Min. Negotiated Rate	$130.20
Max. Negotiated Rate	$297.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$204.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$186.00
Rate for Payer: Aetna Government	$186.00
Rate for Payer: Brighton Health Commercial	$279.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$297.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$252.96
Rate for Payer: Group Health Inc Commercial	$186.00
Rate for Payer: Group Health Inc Medicare	$130.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$186.00
Rate for Payer: Hamaspik Choice Inc Medicare	$186.00

KIT, SPINAL, MIZUHOSI OIS

Facility

$139.58

Hospital Charge Code	64905972
Hospital Revenue Code	270
Min. Negotiated Rate	$48.85
Max. Negotiated Rate	$111.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$76.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.79
Rate for Payer: Aetna Government	$69.79
Rate for Payer: Brighton Health Commercial	$104.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$94.91
Rate for Payer: Group Health Inc Commercial	$69.79
Rate for Payer: Group Health Inc Medicare	$48.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.79
Rate for Payer: Hamaspik Choice Inc Medicare	$69.79

KIT STRIP MONITOR F/BLOOD

Facility

$80.00

Hospital Charge Code	64901639
Hospital Revenue Code	270
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$64.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$40.00
Rate for Payer: Aetna Government	$40.00
Rate for Payer: Brighton Health Commercial	$60.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$64.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$54.40
Rate for Payer: Group Health Inc Commercial	$40.00
Rate for Payer: Group Health Inc Medicare	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00

KIT STYLE BALL TIP .014

Facility

$90.00

Hospital Charge Code	64902677
Hospital Revenue Code	270
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Brighton Health Commercial	$67.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

KIT STYLET ACCESS 58CM

Facility

$72.00

Hospital Charge Code	40005900
Hospital Revenue Code	272
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$57.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$36.00
Rate for Payer: Aetna Government	$36.00
Rate for Payer: Brighton Health Commercial	$54.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.96
Rate for Payer: Group Health Inc Commercial	$36.00
Rate for Payer: Group Health Inc Medicare	$25.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.00
Rate for Payer: Hamaspik Choice Inc Medicare	$36.00

KIT STYLET LEAD 0.016 58CML

Facility

$90.00

Hospital Charge Code	64902673
Hospital Revenue Code	270
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Brighton Health Commercial	$67.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

KIT STYLET LEAD .016 52CML J

Facility

$90.00

Hospital Charge Code	64902681
Hospital Revenue Code	270
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Brighton Health Commercial	$67.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

KIT STYLET LEAD 58CML

Facility

$90.00

Hospital Charge Code	64902675
Hospital Revenue Code	270
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Brighton Health Commercial	$67.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

KIT SUCTION 14FR L/F DYND

Facility

$1.35

Hospital Charge Code	64902213
Hospital Revenue Code	270
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$1.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.68
Rate for Payer: Aetna Government	$0.68
Rate for Payer: Brighton Health Commercial	$1.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.92
Rate for Payer: Group Health Inc Commercial	$0.68
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.68
Rate for Payer: Hamaspik Choice Inc Medicare	$0.68

KIT SUCTION 18FR.

Facility

$2.20

Hospital Charge Code	64902196
Hospital Revenue Code	270
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$1.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.10
Rate for Payer: Aetna Government	$1.10
Rate for Payer: Brighton Health Commercial	$1.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.50
Rate for Payer: Group Health Inc Commercial	$1.10
Rate for Payer: Group Health Inc Medicare	$0.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1.10

KIT SUCTION 6FR.

Facility

$1.46

Hospital Charge Code	64902157
Hospital Revenue Code	270
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$1.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.73
Rate for Payer: Aetna Government	$0.73
Rate for Payer: Brighton Health Commercial	$1.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.99
Rate for Payer: Group Health Inc Commercial	$0.73
Rate for Payer: Group Health Inc Medicare	$0.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.73
Rate for Payer: Hamaspik Choice Inc Medicare	$0.73

KIT SUCTION 8FR.

Facility

$1.46

Hospital Charge Code	64901730
Hospital Revenue Code	270
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$1.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.73
Rate for Payer: Aetna Government	$0.73
Rate for Payer: Brighton Health Commercial	$1.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.99
Rate for Payer: Group Health Inc Commercial	$0.73
Rate for Payer: Group Health Inc Medicare	$0.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.73
Rate for Payer: Hamaspik Choice Inc Medicare	$0.73

KIT SURGIFOAM GELATIN POWDER 1G

Facility

$249.56

Hospital Charge Code	40200493
Hospital Revenue Code	270
Min. Negotiated Rate	$87.35
Max. Negotiated Rate	$199.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$137.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$124.78
Rate for Payer: Aetna Government	$124.78
Rate for Payer: Brighton Health Commercial	$187.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$199.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$169.70
Rate for Payer: Group Health Inc Commercial	$124.78
Rate for Payer: Group Health Inc Medicare	$87.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$124.78
Rate for Payer: Hamaspik Choice Inc Medicare	$124.78

KIT SWVL DX 3.5 X 8.5MM

Facility

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	64906978
Hospital Revenue Code	278
Min. Negotiated Rate	$343.75
Max. Negotiated Rate	$343.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$343.75
Rate for Payer: Hamaspik Choice Inc Medicare	$343.75

KIT SWVL DX 3.5 X 8.5MM

Facility

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	64906978
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$721.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$378.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$412.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$343.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$395.31
Rate for Payer: EmblemHealth Commercial	$343.75
Rate for Payer: Fidelis Medicare Advantage	$721.88
Rate for Payer: Group Health Inc Commercial	$343.75
Rate for Payer: Group Health Inc Medicare	$240.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$343.75
Rate for Payer: Hamaspik Choice Inc Medicare	$343.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$446.88

KIT SYR INJ STLL FX

Facility

$32.08

Hospital Charge Code	64907355
Hospital Revenue Code	270
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$25.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.04
Rate for Payer: Aetna Government	$16.04
Rate for Payer: Brighton Health Commercial	$24.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.81
Rate for Payer: Group Health Inc Commercial	$16.04
Rate for Payer: Group Health Inc Medicare	$11.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.04
Rate for Payer: Hamaspik Choice Inc Medicare	$16.04

KIT URINE CUP 13 X 75 STREAM STE

Facility

$2.02

Hospital Charge Code	64902011
Hospital Revenue Code	270
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$1.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.01
Rate for Payer: Aetna Government	$1.01
Rate for Payer: Brighton Health Commercial	$1.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.37
Rate for Payer: Group Health Inc Commercial	$1.01
Rate for Payer: Group Health Inc Medicare	$0.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01
Rate for Payer: Hamaspik Choice Inc Medicare	$1.01

KIT VENTRICULOSTOMY GHAJAR

Facility

$1,082.50

Hospital Charge Code	64904123
Hospital Revenue Code	270
Min. Negotiated Rate	$378.88
Max. Negotiated Rate	$866.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$595.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$541.25
Rate for Payer: Aetna Government	$541.25
Rate for Payer: Brighton Health Commercial	$811.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$866.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$736.10
Rate for Payer: Group Health Inc Commercial	$541.25
Rate for Payer: Group Health Inc Medicare	$378.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$541.25
Rate for Payer: Hamaspik Choice Inc Medicare	$541.25

KIT, WRIST, STERILE 15X200MM

Facility

$3,599.38

Hospital Charge Code	64903161
Hospital Revenue Code	279
Min. Negotiated Rate	$1,259.78
Max. Negotiated Rate	$2,879.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,979.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,799.69
Rate for Payer: Aetna Government	$1,799.69
Rate for Payer: Brighton Health Commercial	$2,699.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,879.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,447.58
Rate for Payer: Group Health Inc Commercial	$1,799.69
Rate for Payer: Group Health Inc Medicare	$1,259.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,799.69
Rate for Payer: Hamaspik Choice Inc Medicare	$1,799.69

KLEINHERT KUTZ SKIN HOOK 3MM

Facility

$54.25

Hospital Charge Code	64903620
Hospital Revenue Code	270
Min. Negotiated Rate	$18.99
Max. Negotiated Rate	$43.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.12
Rate for Payer: Aetna Government	$27.12
Rate for Payer: Brighton Health Commercial	$40.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.89
Rate for Payer: Group Health Inc Commercial	$27.12
Rate for Payer: Group Health Inc Medicare	$18.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.12
Rate for Payer: Hamaspik Choice Inc Medicare	$27.12

KLING BANDAGE

Facility

$4.25

Hospital Charge Code	40000240
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$3.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.12
Rate for Payer: Aetna Government	$2.12
Rate for Payer: Brighton Health Commercial	$3.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.89
Rate for Payer: Group Health Inc Commercial	$2.12
Rate for Payer: Group Health Inc Medicare	$1.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2.12

KLING BANDAGE

Facility

$6.73

Hospital Charge Code	40203420
Hospital Revenue Code	270
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.36
Rate for Payer: Aetna Government	$3.36
Rate for Payer: Brighton Health Commercial	$5.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.36
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.36
Rate for Payer: Hamaspik Choice Inc Medicare	$3.36

KLS 1.1X7MM DRILL BIT W/STOP

Facility

$264.00

Hospital Charge Code	40205678
Hospital Revenue Code	270
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$211.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$145.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$132.00
Rate for Payer: Aetna Government	$132.00
Rate for Payer: Brighton Health Commercial	$198.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$211.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$179.52
Rate for Payer: Group Health Inc Commercial	$132.00
Rate for Payer: Group Health Inc Medicare	$92.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.00
Rate for Payer: Hamaspik Choice Inc Medicare	$132.00

Know your out-of-pocket cost for care.

All Charges