St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PASSER MED CIRCLAGE

Facility

$562.50

Service Code	HCPCS C1889
Hospital Charge Code	64907471
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$281.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.25
Rate for Payer: Hamaspik Choice Inc Medicare	$281.25

PASSIVE TENDON IMPLANT 4MMX25CM

Facility

$2,476.00

Service Code	HCPCS C1768
Hospital Charge Code	40202076
Hospital Revenue Code	278
Min. Negotiated Rate	$1,238.00
Max. Negotiated Rate	$1,238.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,238.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,238.00

PASSIVE TENDON IMPLANT 4MMX25CM

Facility

$2,476.00

Service Code	HCPCS C1768
Hospital Charge Code	40202076
Hospital Revenue Code	278
Min. Negotiated Rate	$322.77
Max. Negotiated Rate	$2,599.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,361.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$322.77
Rate for Payer: Aetna Government	$322.77
Rate for Payer: Brighton Health Commercial	$1,485.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,238.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,423.70
Rate for Payer: EmblemHealth Commercial	$1,238.00
Rate for Payer: Fidelis Medicare Advantage	$2,599.80
Rate for Payer: Group Health Inc Commercial	$1,238.00
Rate for Payer: Group Health Inc Medicare	$866.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,238.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,238.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,609.40

PASSIVE TENDON IMPLANT 5MMX25CM

Facility

$2,476.00

Service Code	HCPCS C1768
Hospital Charge Code	40202077
Hospital Revenue Code	278
Min. Negotiated Rate	$322.77
Max. Negotiated Rate	$2,599.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,361.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$322.77
Rate for Payer: Aetna Government	$322.77
Rate for Payer: Brighton Health Commercial	$1,485.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,238.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,423.70
Rate for Payer: EmblemHealth Commercial	$1,238.00
Rate for Payer: Fidelis Medicare Advantage	$2,599.80
Rate for Payer: Group Health Inc Commercial	$1,238.00
Rate for Payer: Group Health Inc Medicare	$866.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,238.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,238.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,609.40

PASSIVE TENDON IMPLANT 5MMX25CM

Facility

$2,476.00

Service Code	HCPCS C1768
Hospital Charge Code	40202077
Hospital Revenue Code	278
Min. Negotiated Rate	$1,238.00
Max. Negotiated Rate	$1,238.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,238.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,238.00

PASSY-MUIR TRACH SPEAKING VALVE

Facility

$121.91

Service Code	HCPCS L8501
Hospital Charge Code	40307450
Hospital Revenue Code	274
Min. Negotiated Rate	$42.67
Max. Negotiated Rate	$128.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.10
Rate for Payer: Aetna Government	$63.10
Rate for Payer: Brighton Health Commercial	$73.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$70.10
Rate for Payer: EmblemHealth Commercial	$60.96
Rate for Payer: Fidelis Medicare Advantage	$128.01
Rate for Payer: Group Health Inc Commercial	$60.96
Rate for Payer: Group Health Inc Medicare	$42.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.96
Rate for Payer: Hamaspik Choice Inc Medicare	$60.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$79.24

PASTE ADAPT

Facility

$1.85

Hospital Charge Code	40201972
Hospital Revenue Code	270
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$1.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.93
Rate for Payer: Aetna Government	$0.93
Rate for Payer: Brighton Health Commercial	$1.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.26
Rate for Payer: Group Health Inc Commercial	$0.93
Rate for Payer: Group Health Inc Medicare	$0.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.93
Rate for Payer: Hamaspik Choice Inc Medicare	$0.93

PASTE ADAPT .5OZ TUBE(79301)

Facility

$14.83

Hospital Charge Code	64906486
Hospital Revenue Code	270
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$11.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.42
Rate for Payer: Aetna Government	$7.42
Rate for Payer: Brighton Health Commercial	$11.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.08
Rate for Payer: Group Health Inc Commercial	$7.42
Rate for Payer: Group Health Inc Medicare	$5.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.42
Rate for Payer: Hamaspik Choice Inc Medicare	$7.42

PASTE RAPID SETTING 10CC

Facility

$4,487.50

Service Code	HCPCS C1713
Hospital Charge Code	64903992
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,711.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,468.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,692.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,243.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,580.31
Rate for Payer: EmblemHealth Commercial	$2,243.75
Rate for Payer: Fidelis Medicare Advantage	$4,711.88
Rate for Payer: Group Health Inc Commercial	$2,243.75
Rate for Payer: Group Health Inc Medicare	$1,570.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,243.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,916.88

PASTE RAPID SETTING 10CC

Facility

$4,487.50

Service Code	HCPCS C1713
Hospital Charge Code	64903992
Hospital Revenue Code	278
Min. Negotiated Rate	$2,243.75
Max. Negotiated Rate	$2,243.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,243.75

PASTE RAPID SETTING 20CC

Facility

$8,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64903987
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,898.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,661.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5,085.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,237.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,873.12
Rate for Payer: EmblemHealth Commercial	$4,237.50
Rate for Payer: Fidelis Medicare Advantage	$8,898.75
Rate for Payer: Group Health Inc Commercial	$4,237.50
Rate for Payer: Group Health Inc Medicare	$2,966.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,237.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4,237.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,508.75

PASTE RAPID SETTING 20CC

Facility

$8,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64903987
Hospital Revenue Code	278
Min. Negotiated Rate	$4,237.50
Max. Negotiated Rate	$4,237.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,237.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4,237.50

PATCH/APPLIC # TEST

Facility

$2,752.98

Service Code	HCPCS 95044
Hospital Charge Code	30301413
Hospital Revenue Code	924
Rate for Payer: Cash Price	$1,209.08

PATCH/APPLIC # TEST

Facility

$2,752.98

Service Code	HCPCS 95044
Hospital Charge Code	30301413
Hospital Revenue Code	924
Min. Negotiated Rate	$846.36
Max. Negotiated Rate	$2,202.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,514.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,209.08
Rate for Payer: Aetna Government	$1,209.08
Rate for Payer: Affinity Essential Plan 1&2	$846.36
Rate for Payer: Affinity Essential Plan 3&4	$846.36
Rate for Payer: Affinity Medicaid/CHP/HARP	$846.36
Rate for Payer: Brighton Health Commercial	$2,064.74
Rate for Payer: Cash Price	$1,209.08
Rate for Payer: Cash Price	$1,209.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,209.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,202.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,872.03
Rate for Payer: Elderplan Medicare Advantage	$1,209.08
Rate for Payer: EmblemHealth Commercial	$1,209.08
Rate for Payer: Fidelis Essential Plan Aliesa	$1,027.72
Rate for Payer: Fidelis Essential Plan QHP	$1,076.08
Rate for Payer: Fidelis Medicare Advantage	$1,209.08
Rate for Payer: Fidelis Qualified Health Plan	$1,076.08
Rate for Payer: Group Health Inc Commercial	$1,209.08
Rate for Payer: Group Health Inc Medicare	$1,209.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,376.49
Rate for Payer: Hamaspik Choice Inc Medicare	$1,209.08
Rate for Payer: Healthfirst Medicare Advantage	$1,027.72
Rate for Payer: Healthfirst QHP	$1,209.08
Rate for Payer: Humana Medicare	$1,233.26
Rate for Payer: Senior Whole Health Medicare Advantage	$1,209.08
Rate for Payer: United Healthcare Commercial	$1,376.49
Rate for Payer: United Healthcare Medicare Advantage	$1,209.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,209.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$967.26
Rate for Payer: Wellcare Medicare	$1,148.63

PATCH CARDIOVASCULAR

Facility

$484.00

Service Code	HCPCS C1762
Hospital Charge Code	40200243
Hospital Revenue Code	278
Min. Negotiated Rate	$169.40
Max. Negotiated Rate	$1,879.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$266.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,879.82
Rate for Payer: Aetna Government	$1,879.82
Rate for Payer: Brighton Health Commercial	$290.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$242.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$278.30
Rate for Payer: EmblemHealth Commercial	$242.00
Rate for Payer: Fidelis Medicare Advantage	$508.20
Rate for Payer: Group Health Inc Commercial	$242.00
Rate for Payer: Group Health Inc Medicare	$169.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.00
Rate for Payer: Hamaspik Choice Inc Medicare	$242.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$314.60

PATCH CARDIOVASCULAR

Facility

$605.00

Hospital Charge Code	64902725
Hospital Revenue Code	270
Min. Negotiated Rate	$211.75
Max. Negotiated Rate	$484.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$332.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$302.50
Rate for Payer: Aetna Government	$302.50
Rate for Payer: Brighton Health Commercial	$453.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$484.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$411.40
Rate for Payer: Group Health Inc Commercial	$302.50
Rate for Payer: Group Health Inc Medicare	$211.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$302.50
Rate for Payer: Hamaspik Choice Inc Medicare	$302.50

PATCH CARDIOVASCULAR

Facility

$484.00

Service Code	HCPCS C1762
Hospital Charge Code	40200243
Hospital Revenue Code	278
Min. Negotiated Rate	$242.00
Max. Negotiated Rate	$242.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.00
Rate for Payer: Hamaspik Choice Inc Medicare	$242.00

PATCH CARDIOVASCULAR 5X15

Facility

$990.00

Service Code	HCPCS C1762
Hospital Charge Code	40200244
Hospital Revenue Code	278
Min. Negotiated Rate	$495.00
Max. Negotiated Rate	$495.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$495.00
Rate for Payer: Hamaspik Choice Inc Medicare	$495.00

PATCH CARDIOVASCULAR 5X15

Facility

$990.00

Service Code	HCPCS C1762
Hospital Charge Code	40200244
Hospital Revenue Code	278
Min. Negotiated Rate	$346.50
Max. Negotiated Rate	$1,879.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$544.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,879.82
Rate for Payer: Aetna Government	$1,879.82
Rate for Payer: Brighton Health Commercial	$594.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$495.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$569.25
Rate for Payer: EmblemHealth Commercial	$495.00
Rate for Payer: Fidelis Medicare Advantage	$1,039.50
Rate for Payer: Group Health Inc Commercial	$495.00
Rate for Payer: Group Health Inc Medicare	$346.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$495.00
Rate for Payer: Hamaspik Choice Inc Medicare	$495.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$643.50

PATCH HERNIA COM KUGEL SM OVAL

Facility

$2,130.00

Service Code	HCPCS C1762
Hospital Charge Code	40209643
Hospital Revenue Code	278
Min. Negotiated Rate	$745.50
Max. Negotiated Rate	$2,236.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,171.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,879.82
Rate for Payer: Aetna Government	$1,879.82
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

PATCH HERNIA COM KUGEL SM OVAL

Facility

$2,130.00

Service Code	HCPCS C1762
Hospital Charge Code	40209643
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

PATCH HERNIA MESH 3DMAX 4X6 LG

Facility

$584.53

Service Code	HCPCS C1781
Hospital Charge Code	64901347
Hospital Revenue Code	278
Min. Negotiated Rate	$292.26
Max. Negotiated Rate	$292.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$292.26
Rate for Payer: Hamaspik Choice Inc Medicare	$292.26

PATCH HERNIA MESH 3DMAX 4X6 LG

Facility

$584.53

Service Code	HCPCS C1781
Hospital Charge Code	64901347
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$613.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$321.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$350.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$292.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$336.10
Rate for Payer: EmblemHealth Commercial	$292.26
Rate for Payer: Fidelis Medicare Advantage	$613.76
Rate for Payer: Group Health Inc Commercial	$292.26
Rate for Payer: Group Health Inc Medicare	$204.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$292.26
Rate for Payer: Hamaspik Choice Inc Medicare	$292.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$379.94

PATCH HERNIA VENTRALEX LRG 8CM

Facility

$1,648.00

Service Code	HCPCS C1781
Hospital Charge Code	64901708
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,730.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$906.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$988.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$824.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$947.60
Rate for Payer: EmblemHealth Commercial	$824.00
Rate for Payer: Fidelis Medicare Advantage	$1,730.40
Rate for Payer: Group Health Inc Commercial	$824.00
Rate for Payer: Group Health Inc Medicare	$576.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$824.00
Rate for Payer: Hamaspik Choice Inc Medicare	$824.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,071.20

PATCH HERNIA VENTRALEX LRG 8CM

Facility

$1,648.00

Service Code	HCPCS C1781
Hospital Charge Code	64901708
Hospital Revenue Code	278
Min. Negotiated Rate	$824.00
Max. Negotiated Rate	$824.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$824.00
Rate for Payer: Hamaspik Choice Inc Medicare	$824.00

Know your out-of-pocket cost for care.

All Charges