St. Barnabas Hospital

All Charges

Charge

Type

Price

BAMLANIVIMAB-XXXX INFUSION

Facility OP

$309.60

Service Code	HCPCS M0239
Hospital Charge Code	30300257
Hospital Revenue Code	260
Min. Negotiated Rate	$108.36
Max. Negotiated Rate	$247.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$170.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$154.80
Rate for Payer: Aetna Government	$154.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$247.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$210.53
Rate for Payer: Group Health Inc Commercial	$154.80
Rate for Payer: Group Health Inc Medicare	$108.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.80
Rate for Payer: Hamaspik Choice Inc Medicare	$154.80

BAMLANIVIMAB-XXXX INFUSION

Facility IP

$0.01

Service Code	HCPCS Q0245
Hospital Charge Code	41650202
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

BANANA PEEL SHTH 11 15

Facility OP

$146.72

Hospital Charge Code	41567059
Hospital Revenue Code	270
Min. Negotiated Rate	$51.35
Max. Negotiated Rate	$117.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.36
Rate for Payer: Aetna Government	$73.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$117.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.77
Rate for Payer: Group Health Inc Commercial	$73.36
Rate for Payer: Group Health Inc Medicare	$51.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.36
Rate for Payer: Hamaspik Choice Inc Medicare	$73.36

BANDAGE 3 PLY

Facility OP

$12.05

Hospital Charge Code	40200603
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$9.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.02
Rate for Payer: Aetna Government	$6.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.19
Rate for Payer: Group Health Inc Commercial	$6.02
Rate for Payer: Group Health Inc Medicare	$4.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.02
Rate for Payer: Hamaspik Choice Inc Medicare	$6.02

BANDAGE ELASTIC 6 HONECOM BEIGE

Facility OP

$113.00

Hospital Charge Code	64906242
Hospital Revenue Code	270
Min. Negotiated Rate	$39.55
Max. Negotiated Rate	$90.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.50
Rate for Payer: Aetna Government	$56.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.84
Rate for Payer: Group Health Inc Commercial	$56.50
Rate for Payer: Group Health Inc Medicare	$39.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.50
Rate for Payer: Hamaspik Choice Inc Medicare	$56.50

BANDAGE ESMARK 4X9

Facility OP

$5.22

Hospital Charge Code	40201029
Hospital Revenue Code	270
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$4.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.61
Rate for Payer: Aetna Government	$2.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.55
Rate for Payer: Group Health Inc Commercial	$2.61
Rate for Payer: Group Health Inc Medicare	$1.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.61
Rate for Payer: Hamaspik Choice Inc Medicare	$2.61

BANDAGE ESMARK 6X9

Facility OP

$7.30

Hospital Charge Code	40201030
Hospital Revenue Code	270
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$5.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.65
Rate for Payer: Aetna Government	$3.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.96
Rate for Payer: Group Health Inc Commercial	$3.65
Rate for Payer: Group Health Inc Medicare	$2.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.65
Rate for Payer: Hamaspik Choice Inc Medicare	$3.65

BANDAGE ESMARK STERILE 4X12

Facility OP

$13.50

Hospital Charge Code	40201031
Hospital Revenue Code	270
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$10.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.75
Rate for Payer: Aetna Government	$6.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.18
Rate for Payer: Group Health Inc Commercial	$6.75
Rate for Payer: Group Health Inc Medicare	$4.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.75
Rate for Payer: Hamaspik Choice Inc Medicare	$6.75

BANDAGE FIBERGLSS ORTHOGLSS 3X15'

Facility OP

$129.50

Hospital Charge Code	64902398
Hospital Revenue Code	270
Min. Negotiated Rate	$45.32
Max. Negotiated Rate	$103.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$71.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$64.75
Rate for Payer: Aetna Government	$64.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$103.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.06
Rate for Payer: Group Health Inc Commercial	$64.75
Rate for Payer: Group Health Inc Medicare	$45.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$64.75
Rate for Payer: Hamaspik Choice Inc Medicare	$64.75

BANDAID STERILE 3/4 X 3

Facility OP

$0.08

Hospital Charge Code	64901240
Hospital Revenue Code	270
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04

BANDAID STERILE 3/4X3

Facility OP

$0.50

Hospital Charge Code	40209451
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.34
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25

BANDAID TAZ BUGS BANDAIDS

Facility OP

$0.08

Hospital Charge Code	64902433
Hospital Revenue Code	270
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04

BANDING OF HEMORRHOIDS

Facility OP

$2,313.60

Service Code	HCPCS 46221
Hospital Charge Code	40019706
Hospital Revenue Code	360
Min. Negotiated Rate	$213.74
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,056.92
Rate for Payer: Aetna Government	$1,056.92
Rate for Payer: Cash Price	$1,056.92
Rate for Payer: Cash Price	$1,056.92
Rate for Payer: Cash Price	$1,056.92
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,056.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,056.92
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$213.74
Rate for Payer: Fidelis Essential Plan Aliesa	$898.38
Rate for Payer: Fidelis Essential Plan QHP	$940.66
Rate for Payer: Fidelis Medicare Advantage	$1,056.92
Rate for Payer: Fidelis Qualified Health Plan	$940.66
Rate for Payer: Group Health Inc Commercial	$1,056.92
Rate for Payer: Group Health Inc Medicare	$1,056.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,156.80
Rate for Payer: Hamaspik Choice Inc Medicare	$1,056.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$237.49
Rate for Payer: Healthfirst Medicare Advantage	$898.38
Rate for Payer: Healthfirst QHP	$1,056.92
Rate for Payer: Senior Whole Health Medicare Advantage	$1,056.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,056.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$845.54
Rate for Payer: Wellcare Medicare	$1,004.07

BANISH

Facility OP

$14.53

Hospital Charge Code	40200671
Hospital Revenue Code	270
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$11.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.26
Rate for Payer: Aetna Government	$7.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.88
Rate for Payer: Group Health Inc Commercial	$7.26
Rate for Payer: Group Health Inc Medicare	$5.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.26
Rate for Payer: Hamaspik Choice Inc Medicare	$7.26

BANKART PROCEDURE

Facility OP

$18,117.83

Service Code	HCPCS 23455
Hospital Charge Code	40014303
Hospital Revenue Code	360
Min. Negotiated Rate	$1,119.74
Max. Negotiated Rate	$9,058.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8,273.12
Rate for Payer: Aetna Government	$8,273.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8,273.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$8,273.12
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,119.74
Rate for Payer: Fidelis Essential Plan Aliesa	$7,032.15
Rate for Payer: Fidelis Essential Plan QHP	$7,363.08
Rate for Payer: Fidelis Medicare Advantage	$8,273.12
Rate for Payer: Fidelis Qualified Health Plan	$7,363.08
Rate for Payer: Group Health Inc Commercial	$8,273.12
Rate for Payer: Group Health Inc Medicare	$8,273.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,058.92
Rate for Payer: Hamaspik Choice Inc Medicare	$8,273.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,244.15
Rate for Payer: Healthfirst Medicare Advantage	$7,032.15
Rate for Payer: Healthfirst QHP	$8,273.12
Rate for Payer: Senior Whole Health Medicare Advantage	$8,273.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,273.12
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6,618.50
Rate for Payer: Wellcare Medicare	$7,859.46

BAR ARCH ERICH 1-METER ROLL

Facility OP

$72.50

Hospital Charge Code	64904241
Hospital Revenue Code	270
Min. Negotiated Rate	$25.38
Max. Negotiated Rate	$58.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$36.25
Rate for Payer: Aetna Government	$36.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.30
Rate for Payer: Group Health Inc Commercial	$36.25
Rate for Payer: Group Health Inc Medicare	$25.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.25
Rate for Payer: Hamaspik Choice Inc Medicare	$36.25

BARBITURATE CONFIRMATION, UR

Facility OP

$88.95

Service Code	HCPCS 80345
Hospital Charge Code	40609017
Hospital Revenue Code	300
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$71.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.49
Rate for Payer: Group Health Inc Commercial	$44.48
Rate for Payer: Group Health Inc Medicare	$31.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.48
Rate for Payer: Hamaspik Choice Inc Medicare	$44.48

BARBITURATE IDENTIFICATION

Facility OP

$88.95

Service Code	HCPCS 80345
Hospital Charge Code	40602455
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$71.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.49
Rate for Payer: Group Health Inc Commercial	$44.48
Rate for Payer: Group Health Inc Medicare	$31.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.48
Rate for Payer: Hamaspik Choice Inc Medicare	$44.48

BARD ABSORB FIXATION SYS

Facility OP

$140.00

Hospital Charge Code	40205955
Hospital Revenue Code	270
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$112.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.00
Rate for Payer: Aetna Government	$70.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.20
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00

BARD ECLIPSE VENA CAVA FLTR FMRL

Facility IP

$3,118.00

Service Code	HCPCS C1880
Hospital Charge Code	40205283
Hospital Revenue Code	278
Min. Negotiated Rate	$1,559.00
Max. Negotiated Rate	$1,559.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,559.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,559.00

BARD ECLIPSE VENA CAVA FLTR FMRL

Facility OP

$3,118.00

Service Code	HCPCS C1880
Hospital Charge Code	40205283
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$3,273.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,714.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,559.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,792.85
Rate for Payer: Fidelis Medicare Advantage	$3,273.90
Rate for Payer: Group Health Inc Commercial	$1,559.00
Rate for Payer: Group Health Inc Medicare	$1,091.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,559.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,559.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,026.70

BARDEX HANGER

Facility OP

$12.05

Hospital Charge Code	40200605
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$9.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.02
Rate for Payer: Aetna Government	$6.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.19
Rate for Payer: Group Health Inc Commercial	$6.02
Rate for Payer: Group Health Inc Medicare	$4.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.02
Rate for Payer: Hamaspik Choice Inc Medicare	$6.02

BARD MESH COMP. 4.2X6.2ELLIPSE

Facility OP

$1,065.00

Service Code	HCPCS C1781
Hospital Charge Code	40208079
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,118.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$585.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$532.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$612.38
Rate for Payer: Fidelis Medicare Advantage	$1,118.25
Rate for Payer: Group Health Inc Commercial	$532.50
Rate for Payer: Group Health Inc Medicare	$372.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$532.50
Rate for Payer: Hamaspik Choice Inc Medicare	$532.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$692.25

BARD MESH COMP. 4.2X6.2ELLIPSE

Facility IP

$1,065.00

Service Code	HCPCS C1781
Hospital Charge Code	40208079
Hospital Revenue Code	278
Min. Negotiated Rate	$532.50
Max. Negotiated Rate	$532.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$532.50
Rate for Payer: Hamaspik Choice Inc Medicare	$532.50

BARD MESH COMPOSIXL/P 8.2X10.2

Facility IP

$3,286.00

Service Code	HCPCS C1781
Hospital Charge Code	40209914
Hospital Revenue Code	278
Min. Negotiated Rate	$1,643.00
Max. Negotiated Rate	$1,643.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,643.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,643.00

Price Transparency.

All Charges