St. Barnabas Hospital

All Charges

Charge

Type

Price

BARD MESH COMPOSIXL/P 8.2X10.2

Facility OP

$3,286.00

Service Code	HCPCS C1781
Hospital Charge Code	40209914
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$3,450.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,807.30
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	$1,643.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,889.45
Rate for Payer: Fidelis Medicare Advantage	$3,450.30
Rate for Payer: Group Health Inc Commercial	$1,643.00
Rate for Payer: Group Health Inc Medicare	$1,150.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,643.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,643.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,135.90

BARD MESH HERNIA COMP KUGEL LG OV

Facility OP

$5,074.00

Service Code	HCPCS C1781
Hospital Charge Code	40205028
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$5,327.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,790.70
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	$2,537.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,917.55
Rate for Payer: Fidelis Medicare Advantage	$5,327.70
Rate for Payer: Group Health Inc Commercial	$2,537.00
Rate for Payer: Group Health Inc Medicare	$1,775.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,537.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,537.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,298.10

BARD MESH HERNIA COMP KUGEL LG OV

Facility IP

$5,074.00

Service Code	HCPCS C1781
Hospital Charge Code	40205028
Hospital Revenue Code	278
Min. Negotiated Rate	$2,537.00
Max. Negotiated Rate	$2,537.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,537.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,537.00

BARD MESH KNITD POLY 2X4

Facility OP

$3,164.00

Service Code	HCPCS C1781
Hospital Charge Code	40209920
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$3,322.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,740.20
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	$1,582.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,819.30
Rate for Payer: Fidelis Medicare Advantage	$3,322.20
Rate for Payer: Group Health Inc Commercial	$1,582.00
Rate for Payer: Group Health Inc Medicare	$1,107.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,582.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,056.60

BARD MESH KNITD POLY 2X4

Facility IP

$3,164.00

Service Code	HCPCS C1781
Hospital Charge Code	40209920
Hospital Revenue Code	278
Min. Negotiated Rate	$1,582.00
Max. Negotiated Rate	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,582.00

BARD MESH KNITTED POLY 1X4

Facility OP

$3,164.00

Service Code	HCPCS C1781
Hospital Charge Code	40209081
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$3,322.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,740.20
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	$1,582.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,819.30
Rate for Payer: Fidelis Medicare Advantage	$3,322.20
Rate for Payer: Group Health Inc Commercial	$1,582.00
Rate for Payer: Group Health Inc Medicare	$1,107.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,582.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,056.60

BARD MESH KNITTED POLY 1X4

Facility IP

$3,164.00

Service Code	HCPCS C1781
Hospital Charge Code	40209081
Hospital Revenue Code	278
Min. Negotiated Rate	$1,582.00
Max. Negotiated Rate	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,582.00

BARD MESH PERFIX PLG 1.6X2 X-LG

Facility OP

$698.00

Service Code	HCPCS C1781
Hospital Charge Code	40209973
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$732.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$383.90
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	$349.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$401.35
Rate for Payer: Fidelis Medicare Advantage	$732.90
Rate for Payer: Group Health Inc Commercial	$349.00
Rate for Payer: Group Health Inc Medicare	$244.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$349.00
Rate for Payer: Hamaspik Choice Inc Medicare	$349.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$453.70

BARD MESH PERFIX PLG 1.6X2 X-LG

Facility IP

$698.00

Service Code	HCPCS C1781
Hospital Charge Code	40209973
Hospital Revenue Code	278
Min. Negotiated Rate	$349.00
Max. Negotiated Rate	$349.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$349.00
Rate for Payer: Hamaspik Choice Inc Medicare	$349.00

BARD MESH PERFIX PLUG LARGE

Facility OP

$598.00

Service Code	HCPCS C1781
Hospital Charge Code	40209972
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$627.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$328.90
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	$299.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$343.85
Rate for Payer: Fidelis Medicare Advantage	$627.90
Rate for Payer: Group Health Inc Commercial	$299.00
Rate for Payer: Group Health Inc Medicare	$209.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$299.00
Rate for Payer: Hamaspik Choice Inc Medicare	$299.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$388.70

BARD MESH PERFIX PLUG LARGE

Facility IP

$598.00

Service Code	HCPCS C1781
Hospital Charge Code	40209972
Hospital Revenue Code	278
Min. Negotiated Rate	$299.00
Max. Negotiated Rate	$299.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$299.00
Rate for Payer: Hamaspik Choice Inc Medicare	$299.00

BARD MESH PRFX PLUG MED

Facility IP

$581.32

Service Code	HCPCS C1781
Hospital Charge Code	40209919
Hospital Revenue Code	278
Min. Negotiated Rate	$290.66
Max. Negotiated Rate	$290.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.66
Rate for Payer: Hamaspik Choice Inc Medicare	$290.66

BARD MESH PRFX PLUG MED

Facility OP

$581.32

Service Code	HCPCS C1781
Hospital Charge Code	40209919
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$610.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$319.73
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	$290.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$334.26
Rate for Payer: Fidelis Medicare Advantage	$610.39
Rate for Payer: Group Health Inc Commercial	$290.66
Rate for Payer: Group Health Inc Medicare	$203.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.66
Rate for Payer: Hamaspik Choice Inc Medicare	$290.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$377.86

BARDMESH PRFX PLUG MED/KNIT POLY

Facility OP

$3,164.00

Service Code	HCPCS C1781
Hospital Charge Code	40209918
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$3,322.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,740.20
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	$1,582.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,819.30
Rate for Payer: Fidelis Medicare Advantage	$3,322.20
Rate for Payer: Group Health Inc Commercial	$1,582.00
Rate for Payer: Group Health Inc Medicare	$1,107.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,582.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,056.60

BARDMESH PRFX PLUG MED/KNIT POLY

Facility IP

$3,164.00

Service Code	HCPCS C1781
Hospital Charge Code	40209918
Hospital Revenue Code	278
Min. Negotiated Rate	$1,582.00
Max. Negotiated Rate	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,582.00

BARD PATCH HERNIA COMP/K LG OVAL

Facility IP

$1,268.50

Service Code	HCPCS C1781
Hospital Charge Code	40205619
Hospital Revenue Code	278
Min. Negotiated Rate	$634.25
Max. Negotiated Rate	$634.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$634.25
Rate for Payer: Hamaspik Choice Inc Medicare	$634.25

BARD PATCH HERNIA COMP/K LG OVAL

Facility OP

$1,268.50

Service Code	HCPCS C1781
Hospital Charge Code	40205619
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,331.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$697.68
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	$634.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$729.39
Rate for Payer: Fidelis Medicare Advantage	$1,331.92
Rate for Payer: Group Health Inc Commercial	$634.25
Rate for Payer: Group Health Inc Medicare	$443.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$634.25
Rate for Payer: Hamaspik Choice Inc Medicare	$634.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$824.52

BARD PATCH HERNIA COMP S OVAL

Facility OP

$2,872.00

Hospital Charge Code	40205797
Hospital Revenue Code	272
Min. Negotiated Rate	$1,005.20
Max. Negotiated Rate	$2,297.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,579.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,436.00
Rate for Payer: Aetna Government	$1,436.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,297.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,952.96
Rate for Payer: Group Health Inc Commercial	$1,436.00
Rate for Payer: Group Health Inc Medicare	$1,005.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,436.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,436.00

BARD PTCH HERN COMP KUGEL OVAL XL

Facility IP

$3,200.00

Service Code	HCPCS C1781
Hospital Charge Code	40206097
Hospital Revenue Code	278
Min. Negotiated Rate	$1,600.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,600.00

BARD PTCH HERN COMP KUGEL OVAL XL

Facility OP

$3,200.00

Service Code	HCPCS C1781
Hospital Charge Code	40206097
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$3,360.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,760.00
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	$1,600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,840.00
Rate for Payer: Fidelis Medicare Advantage	$3,360.00
Rate for Payer: Group Health Inc Commercial	$1,600.00
Rate for Payer: Group Health Inc Medicare	$1,120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,600.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,080.00

BARD PTCH HERN COMP KUGEL SM 3X3

Facility IP

$2,014.00

Service Code	HCPCS C1781
Hospital Charge Code	40205009
Hospital Revenue Code	278
Min. Negotiated Rate	$1,007.00
Max. Negotiated Rate	$1,007.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,007.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,007.00

BARD PTCH HERN COMP KUGEL SM 3X3

Facility OP

$2,014.00

Service Code	HCPCS C1781
Hospital Charge Code	40205009
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$2,114.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,107.70
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	$1,007.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,158.05
Rate for Payer: Fidelis Medicare Advantage	$2,114.70
Rate for Payer: Group Health Inc Commercial	$1,007.00
Rate for Payer: Group Health Inc Medicare	$704.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,007.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,007.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,309.10

BARD PTH HERNIA V LG W/CIRCLE

Facility OP

$962.00

Hospital Charge Code	40205155
Hospital Revenue Code	272
Min. Negotiated Rate	$336.70
Max. Negotiated Rate	$769.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$529.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$481.00
Rate for Payer: Aetna Government	$481.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$769.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$654.16
Rate for Payer: Group Health Inc Commercial	$481.00
Rate for Payer: Group Health Inc Medicare	$336.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$481.00
Rate for Payer: Hamaspik Choice Inc Medicare	$481.00

BARD SITE RITE COVER W/GEL

Facility OP

$13.60

Hospital Charge Code	40206284
Hospital Revenue Code	270
Min. Negotiated Rate	$4.76
Max. Negotiated Rate	$10.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.80
Rate for Payer: Aetna Government	$6.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.25
Rate for Payer: Group Health Inc Commercial	$6.80
Rate for Payer: Group Health Inc Medicare	$4.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.80
Rate for Payer: Hamaspik Choice Inc Medicare	$6.80

BARD VENTRIO H/P 11.4CM X11.4CM

Facility OP

$2,179.84

Service Code	HCPCS C1781
Hospital Charge Code	40207041
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$2,288.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,198.91
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	$1,089.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,253.41
Rate for Payer: Fidelis Medicare Advantage	$2,288.83
Rate for Payer: Group Health Inc Commercial	$1,089.92
Rate for Payer: Group Health Inc Medicare	$762.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,089.92
Rate for Payer: Hamaspik Choice Inc Medicare	$1,089.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,416.90

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