St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MESH VENTRALIGHT 8 X 10

Facility

$5,509.50

Service Code	HCPCS C1781
Hospital Charge Code	64905935
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$5,784.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,030.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$3,305.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,754.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,167.96
Rate for Payer: EmblemHealth Commercial	$2,754.75
Rate for Payer: Fidelis Medicare Advantage	$5,784.98
Rate for Payer: Group Health Inc Commercial	$2,754.75
Rate for Payer: Group Health Inc Medicare	$1,928.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,754.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,754.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,581.18

MESH,VENTRALIGHT,PERM,CIRC,4.5

Facility

$2,350.00

Service Code	HCPCS C1781
Hospital Charge Code	64902682
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.00
Max. Negotiated Rate	$1,175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,175.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,175.00

MESH,VENTRALIGHT,PERM,CIRC,4.5

Facility

$2,350.00

Service Code	HCPCS C1781
Hospital Charge Code	64902682
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$2,467.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,292.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,410.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,175.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,351.25
Rate for Payer: EmblemHealth Commercial	$1,175.00
Rate for Payer: Fidelis Medicare Advantage	$2,467.50
Rate for Payer: Group Health Inc Commercial	$1,175.00
Rate for Payer: Group Health Inc Medicare	$822.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,175.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,175.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,527.50

MESH,VENTRALIGHT ST,4X6 ELL

Facility

$1,857.75

Service Code	HCPCS C1781
Hospital Charge Code	64902685
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,950.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,021.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,114.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$928.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,068.21
Rate for Payer: EmblemHealth Commercial	$928.88
Rate for Payer: Fidelis Medicare Advantage	$1,950.64
Rate for Payer: Group Health Inc Commercial	$928.88
Rate for Payer: Group Health Inc Medicare	$650.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$928.88
Rate for Payer: Hamaspik Choice Inc Medicare	$928.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,207.54

MESH,VENTRALIGHT ST,4X6 ELL

Facility

$1,857.75

Service Code	HCPCS C1781
Hospital Charge Code	64902685
Hospital Revenue Code	278
Min. Negotiated Rate	$928.88
Max. Negotiated Rate	$928.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$928.88
Rate for Payer: Hamaspik Choice Inc Medicare	$928.88

MESH VENTRALIGHT ST 6 X 10

Facility

$4,164.00

Service Code	HCPCS C1781
Hospital Charge Code	64905931
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$4,372.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,290.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$2,498.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,082.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,394.30
Rate for Payer: EmblemHealth Commercial	$2,082.00
Rate for Payer: Fidelis Medicare Advantage	$4,372.20
Rate for Payer: Group Health Inc Commercial	$2,082.00
Rate for Payer: Group Health Inc Medicare	$1,457.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,082.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,082.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,706.60

MESH VENTRALIGHT ST 6 X 10

Facility

$4,164.00

Service Code	HCPCS C1781
Hospital Charge Code	64905931
Hospital Revenue Code	278
Min. Negotiated Rate	$2,082.00
Max. Negotiated Rate	$2,082.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,082.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,082.00

MESH VENTRALIGHT ST 6 X 8

Facility

$3,254.50

Service Code	HCPCS C1781
Hospital Charge Code	64905929
Hospital Revenue Code	278
Min. Negotiated Rate	$1,627.25
Max. Negotiated Rate	$1,627.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,627.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,627.25

MESH VENTRALIGHT ST 6 X 8

Facility

$3,254.50

Service Code	HCPCS C1781
Hospital Charge Code	64905929
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$3,417.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,789.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,952.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,627.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,871.34
Rate for Payer: EmblemHealth Commercial	$1,627.25
Rate for Payer: Fidelis Medicare Advantage	$3,417.22
Rate for Payer: Group Health Inc Commercial	$1,627.25
Rate for Payer: Group Health Inc Medicare	$1,139.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,627.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,627.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,115.42

MESH V-PATCH C-QUR 4.3 X 4.3CM

Facility

$843.90

Service Code	HCPCS C1781
Hospital Charge Code	64902553
Hospital Revenue Code	278
Min. Negotiated Rate	$421.95
Max. Negotiated Rate	$421.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$421.95
Rate for Payer: Hamaspik Choice Inc Medicare	$421.95

MESH V-PATCH C-QUR 4.3 X 4.3CM

Facility

$843.90

Service Code	HCPCS C1781
Hospital Charge Code	64902553
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$886.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$464.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$506.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$421.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$485.24
Rate for Payer: EmblemHealth Commercial	$421.95
Rate for Payer: Fidelis Medicare Advantage	$886.10
Rate for Payer: Group Health Inc Commercial	$421.95
Rate for Payer: Group Health Inc Medicare	$295.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$421.95
Rate for Payer: Hamaspik Choice Inc Medicare	$421.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$548.54

MESH V-PATCH C-QUR 8.0 X 8.0CM

Facility

$1,389.53

Service Code	HCPCS C1781
Hospital Charge Code	64902577
Hospital Revenue Code	278
Min. Negotiated Rate	$694.76
Max. Negotiated Rate	$694.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$694.76
Rate for Payer: Hamaspik Choice Inc Medicare	$694.76

MESH V-PATCH C-QUR 8.0 X 8.0CM

Facility

$1,389.53

Service Code	HCPCS C1781
Hospital Charge Code	64902577
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,459.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$764.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$833.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$694.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$798.98
Rate for Payer: EmblemHealth Commercial	$694.76
Rate for Payer: Fidelis Medicare Advantage	$1,459.01
Rate for Payer: Group Health Inc Commercial	$694.76
Rate for Payer: Group Health Inc Medicare	$486.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$694.76
Rate for Payer: Hamaspik Choice Inc Medicare	$694.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$903.19

MESNA 100 MG/ML INJ

Facility

$3.00

Hospital Charge Code	41651327
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

MESNA 100 MG/ML INJ

Facility

$3.00

Hospital Charge Code	41651327
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.95
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	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
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

MESNA 100 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	41641327
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.11
Rate for Payer: Aetna Government	$2.11
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
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: SOMOS CHP/HARP/Medicaid	$1.87
Rate for Payer: SOMOS Essential	$1.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

MESNA 100 MG/ML INJ

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	41641327
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

MESNA 100 MG/ML IV SOLN [10537]

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	00338130501
Hospital Revenue Code	278
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$3.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.11
Rate for Payer: Aetna Government	$2.11
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: EmblemHealth Commercial	$1.50
Rate for Payer: Fidelis Medicare Advantage	$3.15
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

MESNA 100 MG/ML IV SOLN [10537]

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	00338130501
Hospital Revenue Code	278
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

MESNA 100 MG/ML IV SOLN [10537]

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	10019095301
Hospital Revenue Code	278
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$3.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.11
Rate for Payer: Aetna Government	$2.11
Rate for Payer: Brighton Health Commercial	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: EmblemHealth Commercial	$1.50
Rate for Payer: Fidelis Medicare Advantage	$3.15
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

MESNA 100 MG/ML IV SOLN [10537]

Facility

$3.00

Service Code	HCPCS J9209
Hospital Charge Code	10019095301
Hospital Revenue Code	278
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

METAL EYE SHIELDS

Facility

$2.48

Hospital Charge Code	40000265
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$1.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.24
Rate for Payer: Aetna Government	$1.24
Rate for Payer: Brighton Health Commercial	$1.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.69
Rate for Payer: Group Health Inc Commercial	$1.24
Rate for Payer: Group Health Inc Medicare	$0.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.24
Rate for Payer: Hamaspik Choice Inc Medicare	$1.24

METANEPHRINES, 24 HOUR URINE

Facility

$42.35

Service Code	HCPCS 83835
Hospital Charge Code	40608108
Hospital Revenue Code	301
Rate for Payer: Cash Price	$16.94

METANEPHRINES, 24 HOUR URINE

Facility

$42.35

Service Code	HCPCS 83835
Hospital Charge Code	40608108
Hospital Revenue Code	301
Min. Negotiated Rate	$11.86
Max. Negotiated Rate	$31.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.94
Rate for Payer: Aetna Government	$16.94
Rate for Payer: Affinity Essential Plan 1&2	$11.86
Rate for Payer: Affinity Essential Plan 3&4	$11.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$11.86
Rate for Payer: Brighton Health Commercial	$31.76
Rate for Payer: Cash Price	$16.94
Rate for Payer: Cash Price	$16.94
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$16.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.79
Rate for Payer: Elderplan Medicare Advantage	$16.94
Rate for Payer: EmblemHealth Commercial	$16.94
Rate for Payer: Fidelis Essential Plan Aliesa	$14.40
Rate for Payer: Fidelis Essential Plan QHP	$15.08
Rate for Payer: Fidelis Medicare Advantage	$16.94
Rate for Payer: Fidelis Qualified Health Plan	$15.08
Rate for Payer: Group Health Inc Commercial	$16.94
Rate for Payer: Group Health Inc Medicare	$16.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.18
Rate for Payer: Hamaspik Choice Inc Medicare	$16.94
Rate for Payer: Healthfirst Medicare Advantage	$16.94
Rate for Payer: Healthfirst QHP	$16.94
Rate for Payer: Humana Medicare	$17.28
Rate for Payer: Senior Whole Health Medicare Advantage	$16.94
Rate for Payer: United Healthcare Commercial	$21.46
Rate for Payer: United Healthcare Medicare Advantage	$16.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$16.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$13.55
Rate for Payer: Wellcare Medicare	$15.25

METANEPHRINES, FRAC., PI. FREE

Facility

$42.35

Service Code	HCPCS 83835
Hospital Charge Code	40609098
Hospital Revenue Code	300
Rate for Payer: Cash Price	$16.94

Know your out-of-pocket cost for care.

All Charges