St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MESH PROLENE 6X6 E-PMH

Facility

$346.25

Service Code	HCPCS C1781
Hospital Charge Code	64901160
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$363.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$207.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$173.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.09
Rate for Payer: EmblemHealth Commercial	$173.12
Rate for Payer: Fidelis Medicare Advantage	$363.56
Rate for Payer: Group Health Inc Commercial	$173.12
Rate for Payer: Group Health Inc Medicare	$121.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.12
Rate for Payer: Hamaspik Choice Inc Medicare	$173.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.06

MESH PROLENE 6X6 E-PMH

Facility

$346.25

Service Code	HCPCS C1781
Hospital Charge Code	64901160
Hospital Revenue Code	278
Min. Negotiated Rate	$173.12
Max. Negotiated Rate	$173.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.12
Rate for Payer: Hamaspik Choice Inc Medicare	$173.12

MESH PROLENE HERNIA SYST/LARGE

Facility

$1,247.02

Service Code	HCPCS C1781
Hospital Charge Code	40209964
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,309.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$685.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$748.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$623.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$717.04
Rate for Payer: EmblemHealth Commercial	$623.51
Rate for Payer: Fidelis Medicare Advantage	$1,309.37
Rate for Payer: Group Health Inc Commercial	$623.51
Rate for Payer: Group Health Inc Medicare	$436.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$623.51
Rate for Payer: Hamaspik Choice Inc Medicare	$623.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$810.56

MESH PROLENE HERNIA SYST/LARGE

Facility

$1,247.02

Service Code	HCPCS C1781
Hospital Charge Code	40209964
Hospital Revenue Code	278
Min. Negotiated Rate	$623.51
Max. Negotiated Rate	$623.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$623.51
Rate for Payer: Hamaspik Choice Inc Medicare	$623.51

MESH PROLENE HERNIA SYST/MED

Facility

$1,247.02

Service Code	HCPCS C1781
Hospital Charge Code	40209963
Hospital Revenue Code	278
Min. Negotiated Rate	$623.51
Max. Negotiated Rate	$623.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$623.51
Rate for Payer: Hamaspik Choice Inc Medicare	$623.51

MESH PROLENE HERNIA SYST/MED

Facility

$1,247.02

Service Code	HCPCS C1781
Hospital Charge Code	40209963
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,309.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$685.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$748.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$623.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$717.04
Rate for Payer: EmblemHealth Commercial	$623.51
Rate for Payer: Fidelis Medicare Advantage	$1,309.37
Rate for Payer: Group Health Inc Commercial	$623.51
Rate for Payer: Group Health Inc Medicare	$436.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$623.51
Rate for Payer: Hamaspik Choice Inc Medicare	$623.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$810.56

MESH PROLENE MEDIUM

Facility

$1,425.90

Service Code	HCPCS C1781
Hospital Charge Code	64901214
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,497.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$784.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$855.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$712.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$819.89
Rate for Payer: EmblemHealth Commercial	$712.95
Rate for Payer: Fidelis Medicare Advantage	$1,497.20
Rate for Payer: Group Health Inc Commercial	$712.95
Rate for Payer: Group Health Inc Medicare	$499.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$712.95
Rate for Payer: Hamaspik Choice Inc Medicare	$712.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$926.84

MESH PROLENE MEDIUM

Facility

$1,425.90

Service Code	HCPCS C1781
Hospital Charge Code	64901214
Hospital Revenue Code	278
Min. Negotiated Rate	$712.95
Max. Negotiated Rate	$712.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$712.95
Rate for Payer: Hamaspik Choice Inc Medicare	$712.95

MESH/SEPRA 3X6

Facility

$420.00

Service Code	HCPCS C1781
Hospital Charge Code	40200923
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

MESH/SEPRA 3X6

Facility

$420.00

Service Code	HCPCS C1781
Hospital Charge Code	40200923
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

MESH/SEPRA 6X8

Facility

$1,200.00

Service Code	HCPCS C1781
Hospital Charge Code	40209969
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,260.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$660.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$720.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$690.00
Rate for Payer: EmblemHealth Commercial	$600.00
Rate for Payer: Fidelis Medicare Advantage	$1,260.00
Rate for Payer: Group Health Inc Commercial	$600.00
Rate for Payer: Group Health Inc Medicare	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$780.00

MESH/SEPRA 6X8

Facility

$1,200.00

Service Code	HCPCS C1781
Hospital Charge Code	40209969
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00

MESH SINGLE LAYER INTE

Facility

$31,315.68

Service Code	HCPCS C1781
Hospital Charge Code	64907425
Hospital Revenue Code	278
Min. Negotiated Rate	$15,657.84
Max. Negotiated Rate	$15,657.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,657.84
Rate for Payer: Hamaspik Choice Inc Medicare	$15,657.84

MESH SINGLE LAYER INTE

Facility

$31,315.68

Service Code	HCPCS C1781
Hospital Charge Code	64907425
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$32,881.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17,223.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$18,789.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15,657.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$18,006.52
Rate for Payer: EmblemHealth Commercial	$15,657.84
Rate for Payer: Fidelis Medicare Advantage	$32,881.46
Rate for Payer: Group Health Inc Commercial	$15,657.84
Rate for Payer: Group Health Inc Medicare	$10,960.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,657.84
Rate for Payer: Hamaspik Choice Inc Medicare	$15,657.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20,355.19

MESH SURGICAL NON 7.5 X 15CM

Facility

$1,187.50

Service Code	HCPCS C1781
Hospital Charge Code	64904770
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,246.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$653.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$712.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$593.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$682.81
Rate for Payer: EmblemHealth Commercial	$593.75
Rate for Payer: Fidelis Medicare Advantage	$1,246.88
Rate for Payer: Group Health Inc Commercial	$593.75
Rate for Payer: Group Health Inc Medicare	$415.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$593.75
Rate for Payer: Hamaspik Choice Inc Medicare	$593.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$771.88

MESH SURGICAL NON 7.5 X 15CM

Facility

$1,187.50

Service Code	HCPCS C1781
Hospital Charge Code	64904770
Hospital Revenue Code	278
Min. Negotiated Rate	$593.75
Max. Negotiated Rate	$593.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$593.75
Rate for Payer: Hamaspik Choice Inc Medicare	$593.75

MESH SURG POLY 3-1 4X4-3/4 OVAL

Facility

$838.00

Service Code	HCPCS C1781
Hospital Charge Code	40200908
Hospital Revenue Code	278
Min. Negotiated Rate	$419.00
Max. Negotiated Rate	$419.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$419.00
Rate for Payer: Hamaspik Choice Inc Medicare	$419.00

MESH SURG POLY 3-1 4X4-3/4 OVAL

Facility

$838.00

Service Code	HCPCS C1781
Hospital Charge Code	40200908
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$879.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$460.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$502.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$419.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$481.85
Rate for Payer: EmblemHealth Commercial	$419.00
Rate for Payer: Fidelis Medicare Advantage	$879.90
Rate for Payer: Group Health Inc Commercial	$419.00
Rate for Payer: Group Health Inc Medicare	$293.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$419.00
Rate for Payer: Hamaspik Choice Inc Medicare	$419.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$544.70

MESH SYTEM HERNIA PATCH 4IN DIA

Facility

$7,031.53

Service Code	HCPCS C1781
Hospital Charge Code	64901187
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$7,383.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,867.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$4,218.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,515.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,043.13
Rate for Payer: EmblemHealth Commercial	$3,515.76
Rate for Payer: Fidelis Medicare Advantage	$7,383.11
Rate for Payer: Group Health Inc Commercial	$3,515.76
Rate for Payer: Group Health Inc Medicare	$2,461.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,515.76
Rate for Payer: Hamaspik Choice Inc Medicare	$3,515.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,570.49

MESH SYTEM HERNIA PATCH 4IN DIA

Facility

$7,031.53

Service Code	HCPCS C1781
Hospital Charge Code	64901187
Hospital Revenue Code	278
Min. Negotiated Rate	$3,515.76
Max. Negotiated Rate	$3,515.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,515.76
Rate for Payer: Hamaspik Choice Inc Medicare	$3,515.76

MESH TEMPORAL

Facility

$1,198.00

Service Code	HCPCS C1781
Hospital Charge Code	40200909
Hospital Revenue Code	278
Min. Negotiated Rate	$599.00
Max. Negotiated Rate	$599.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$599.00
Rate for Payer: Hamaspik Choice Inc Medicare	$599.00

MESH TEMPORAL

Facility

$1,198.00

Service Code	HCPCS C1781
Hospital Charge Code	40200909
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,257.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$658.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$718.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$599.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$688.85
Rate for Payer: EmblemHealth Commercial	$599.00
Rate for Payer: Fidelis Medicare Advantage	$1,257.90
Rate for Payer: Group Health Inc Commercial	$599.00
Rate for Payer: Group Health Inc Medicare	$419.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$599.00
Rate for Payer: Hamaspik Choice Inc Medicare	$599.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$778.70

MESH VENTRALIGHT 8 CIRCLE

Facility

$4,702.25

Service Code	HCPCS C1781
Hospital Charge Code	64905933
Hospital Revenue Code	278
Min. Negotiated Rate	$2,351.12
Max. Negotiated Rate	$2,351.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,351.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,351.12

MESH VENTRALIGHT 8 CIRCLE

Facility

$4,702.25

Service Code	HCPCS C1781
Hospital Charge Code	64905933
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$4,937.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,586.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$2,821.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,351.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,703.79
Rate for Payer: EmblemHealth Commercial	$2,351.12
Rate for Payer: Fidelis Medicare Advantage	$4,937.36
Rate for Payer: Group Health Inc Commercial	$2,351.12
Rate for Payer: Group Health Inc Medicare	$1,645.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,351.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,351.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,056.46

MESH VENTRALIGHT 8 X 10

Facility

$5,509.50

Service Code	HCPCS C1781
Hospital Charge Code	64905935
Hospital Revenue Code	278
Min. Negotiated Rate	$2,754.75
Max. Negotiated Rate	$2,754.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,754.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,754.75

Know your out-of-pocket cost for care.

All Charges