St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MESH KUGEL SM OVL W/EPTFE 8CMX2CM

Facility

$2,130.00

Service Code	HCPCS C1781
Hospital Charge Code	40201115
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$2,236.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,171.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,278.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,065.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,224.75
Rate for Payer: EmblemHealth Commercial	$1,065.00
Rate for Payer: Fidelis Medicare Advantage	$2,236.50
Rate for Payer: Group Health Inc Commercial	$1,065.00
Rate for Payer: Group Health Inc Medicare	$745.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,065.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,065.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,384.50

MESH KUGEL SM OVL W/EPTFE 8CMX2CM

Facility

$2,130.00

Service Code	HCPCS C1781
Hospital Charge Code	40201115
Hospital Revenue Code	278
Min. Negotiated Rate	$1,065.00
Max. Negotiated Rate	$1,065.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,065.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,065.00

MESH MARLEX 2X4

Facility

$261.80

Service Code	HCPCS C1781
Hospital Charge Code	64901085
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$274.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$157.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$130.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.54
Rate for Payer: EmblemHealth Commercial	$130.90
Rate for Payer: Fidelis Medicare Advantage	$274.89
Rate for Payer: Group Health Inc Commercial	$130.90
Rate for Payer: Group Health Inc Medicare	$91.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.90
Rate for Payer: Hamaspik Choice Inc Medicare	$130.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.17

MESH MARLEX 2X4

Facility

$261.80

Service Code	HCPCS C1781
Hospital Charge Code	64901085
Hospital Revenue Code	278
Min. Negotiated Rate	$130.90
Max. Negotiated Rate	$130.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.90
Rate for Payer: Hamaspik Choice Inc Medicare	$130.90

MESH MC MAL 1/1.2 D 120X120X.3

Facility

$4,081.14

Service Code	HCPCS C1781
Hospital Charge Code	64906610
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$4,285.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,244.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$2,448.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,040.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,346.66
Rate for Payer: EmblemHealth Commercial	$2,040.57
Rate for Payer: Fidelis Medicare Advantage	$4,285.20
Rate for Payer: Group Health Inc Commercial	$2,040.57
Rate for Payer: Group Health Inc Medicare	$1,428.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,040.57
Rate for Payer: Hamaspik Choice Inc Medicare	$2,040.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,652.74

MESH MC MAL 1/1.2 D 120X120X.3

Facility

$4,081.14

Service Code	HCPCS C1781
Hospital Charge Code	64906610
Hospital Revenue Code	278
Min. Negotiated Rate	$2,040.57
Max. Negotiated Rate	$2,040.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,040.57
Rate for Payer: Hamaspik Choice Inc Medicare	$2,040.57

MESH MC MAL 1/1.2 D 120X120X.6

Facility

$4,153.24

Service Code	HCPCS C1781
Hospital Charge Code	64906614
Hospital Revenue Code	278
Min. Negotiated Rate	$2,076.62
Max. Negotiated Rate	$2,076.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,076.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,076.62

MESH MC MAL 1/1.2 D 120X120X.6

Facility

$4,153.24

Service Code	HCPCS C1781
Hospital Charge Code	64906614
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$4,360.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,284.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$2,491.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,076.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,388.11
Rate for Payer: EmblemHealth Commercial	$2,076.62
Rate for Payer: Fidelis Medicare Advantage	$4,360.90
Rate for Payer: Group Health Inc Commercial	$2,076.62
Rate for Payer: Group Health Inc Medicare	$1,453.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,076.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,076.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,699.61

MESH MC MAL 1/1.2 D 200X200X.6

Facility

$11,874.02

Service Code	HCPCS C1781
Hospital Charge Code	64906613
Hospital Revenue Code	278
Min. Negotiated Rate	$5,937.01
Max. Negotiated Rate	$5,937.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,937.01
Rate for Payer: Hamaspik Choice Inc Medicare	$5,937.01

MESH MC MAL 1/1.2 D 200X200X.6

Facility

$11,874.02

Service Code	HCPCS C1781
Hospital Charge Code	64906613
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$12,467.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,530.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$7,124.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,937.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,827.56
Rate for Payer: EmblemHealth Commercial	$5,937.01
Rate for Payer: Fidelis Medicare Advantage	$12,467.72
Rate for Payer: Group Health Inc Commercial	$5,937.01
Rate for Payer: Group Health Inc Medicare	$4,155.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,937.01
Rate for Payer: Hamaspik Choice Inc Medicare	$5,937.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,718.11

MESH MIC MAL 1/1.2 DY 40X40X.3

Facility

$2,111.62

Service Code	HCPCS C1781
Hospital Charge Code	64906609
Hospital Revenue Code	278
Min. Negotiated Rate	$1,055.81
Max. Negotiated Rate	$1,055.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,055.81
Rate for Payer: Hamaspik Choice Inc Medicare	$1,055.81

MESH MIC MAL 1/1.2 DY 40X40X.3

Facility

$2,111.62

Service Code	HCPCS C1781
Hospital Charge Code	64906609
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$2,217.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,161.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,266.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,055.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,214.18
Rate for Payer: EmblemHealth Commercial	$1,055.81
Rate for Payer: Fidelis Medicare Advantage	$2,217.20
Rate for Payer: Group Health Inc Commercial	$1,055.81
Rate for Payer: Group Health Inc Medicare	$739.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,055.81
Rate for Payer: Hamaspik Choice Inc Medicare	$1,055.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,372.55

MESH MICRO MALLE 120X120X.1MM

Facility

$1,742.12

Service Code	HCPCS C1781
Hospital Charge Code	64906603
Hospital Revenue Code	278
Min. Negotiated Rate	$871.06
Max. Negotiated Rate	$871.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$871.06
Rate for Payer: Hamaspik Choice Inc Medicare	$871.06

MESH MICRO MALLE 120X120X.1MM

Facility

$1,742.12

Service Code	HCPCS C1781
Hospital Charge Code	64906603
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,829.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$958.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,045.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$871.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,001.72
Rate for Payer: EmblemHealth Commercial	$871.06
Rate for Payer: Fidelis Medicare Advantage	$1,829.23
Rate for Payer: Group Health Inc Commercial	$871.06
Rate for Payer: Group Health Inc Medicare	$609.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$871.06
Rate for Payer: Hamaspik Choice Inc Medicare	$871.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,132.38

MESH MICRO MALLE 120X120X.2MM

Facility

$1,742.12

Service Code	HCPCS C1781
Hospital Charge Code	64906606
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,829.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$958.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,045.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$871.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,001.72
Rate for Payer: EmblemHealth Commercial	$871.06
Rate for Payer: Fidelis Medicare Advantage	$1,829.23
Rate for Payer: Group Health Inc Commercial	$871.06
Rate for Payer: Group Health Inc Medicare	$609.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$871.06
Rate for Payer: Hamaspik Choice Inc Medicare	$871.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,132.38

MESH MICRO MALLE 120X120X.2MM

Facility

$1,742.12

Service Code	HCPCS C1781
Hospital Charge Code	64906606
Hospital Revenue Code	278
Min. Negotiated Rate	$871.06
Max. Negotiated Rate	$871.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$871.06
Rate for Payer: Hamaspik Choice Inc Medicare	$871.06

MESH MICRO MALLE 120X60X.1MM

Facility

$1,301.46

Service Code	HCPCS C1781
Hospital Charge Code	64906604
Hospital Revenue Code	278
Min. Negotiated Rate	$650.73
Max. Negotiated Rate	$650.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.73
Rate for Payer: Hamaspik Choice Inc Medicare	$650.73

MESH MICRO MALLE 120X60X.1MM

Facility

$1,301.46

Service Code	HCPCS C1781
Hospital Charge Code	64906604
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,366.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$715.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$780.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$748.34
Rate for Payer: EmblemHealth Commercial	$650.73
Rate for Payer: Fidelis Medicare Advantage	$1,366.53
Rate for Payer: Group Health Inc Commercial	$650.73
Rate for Payer: Group Health Inc Medicare	$455.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.73
Rate for Payer: Hamaspik Choice Inc Medicare	$650.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$845.95

MESH MICRO MALLE 120X60X.2MM

Facility

$1,301.46

Service Code	HCPCS C1781
Hospital Charge Code	64906607
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,366.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$715.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$780.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$748.34
Rate for Payer: EmblemHealth Commercial	$650.73
Rate for Payer: Fidelis Medicare Advantage	$1,366.53
Rate for Payer: Group Health Inc Commercial	$650.73
Rate for Payer: Group Health Inc Medicare	$455.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.73
Rate for Payer: Hamaspik Choice Inc Medicare	$650.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$845.95

MESH MICRO MALLE 120X60X.2MM

Facility

$1,301.46

Service Code	HCPCS C1781
Hospital Charge Code	64906607
Hospital Revenue Code	278
Min. Negotiated Rate	$650.73
Max. Negotiated Rate	$650.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.73
Rate for Payer: Hamaspik Choice Inc Medicare	$650.73

MESH MICRO MALLE 60X60X.1MM

Facility

$865.08

Service Code	HCPCS C1781
Hospital Charge Code	64906605
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$908.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$475.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$519.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$432.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$497.42
Rate for Payer: EmblemHealth Commercial	$432.54
Rate for Payer: Fidelis Medicare Advantage	$908.33
Rate for Payer: Group Health Inc Commercial	$432.54
Rate for Payer: Group Health Inc Medicare	$302.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$432.54
Rate for Payer: Hamaspik Choice Inc Medicare	$432.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$562.30

MESH MICRO MALLE 60X60X.1MM

Facility

$865.08

Service Code	HCPCS C1781
Hospital Charge Code	64906605
Hospital Revenue Code	278
Min. Negotiated Rate	$432.54
Max. Negotiated Rate	$432.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$432.54
Rate for Payer: Hamaspik Choice Inc Medicare	$432.54

MESH MICRO MALLE 60X60X.2MM

Facility

$865.08

Service Code	HCPCS C1781
Hospital Charge Code	64906608
Hospital Revenue Code	278
Min. Negotiated Rate	$432.54
Max. Negotiated Rate	$432.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$432.54
Rate for Payer: Hamaspik Choice Inc Medicare	$432.54

MESH MICRO MALLE 60X60X.2MM

Facility

$865.08

Service Code	HCPCS C1781
Hospital Charge Code	64906608
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$908.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$475.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$519.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$432.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$497.42
Rate for Payer: EmblemHealth Commercial	$432.54
Rate for Payer: Fidelis Medicare Advantage	$908.33
Rate for Payer: Group Health Inc Commercial	$432.54
Rate for Payer: Group Health Inc Medicare	$302.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$432.54
Rate for Payer: Hamaspik Choice Inc Medicare	$432.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$562.30

MESH MIDFACE INLAY MOD HALF SZ

Facility

$332.50

Service Code	HCPCS C1781
Hospital Charge Code	40202012
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$349.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$182.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$199.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.19
Rate for Payer: EmblemHealth Commercial	$166.25
Rate for Payer: Fidelis Medicare Advantage	$349.12
Rate for Payer: Group Health Inc Commercial	$166.25
Rate for Payer: Group Health Inc Medicare	$116.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.25
Rate for Payer: Hamaspik Choice Inc Medicare	$166.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.12

Know your out-of-pocket cost for care.

All Charges