St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ARM15T ROD 40MM

Facility

$912.50

Service Code	HCPCS C1713
Hospital Charge Code	64903526
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$958.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$501.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$547.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$524.69
Rate for Payer: EmblemHealth Commercial	$456.25
Rate for Payer: Fidelis Medicare Advantage	$958.12
Rate for Payer: Group Health Inc Commercial	$456.25
Rate for Payer: Group Health Inc Medicare	$319.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.25
Rate for Payer: Hamaspik Choice Inc Medicare	$456.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$593.12

ARM 15T ROD 45

Facility

$912.50

Service Code	HCPCS C1713
Hospital Charge Code	64903878
Hospital Revenue Code	278
Min. Negotiated Rate	$456.25
Max. Negotiated Rate	$456.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.25
Rate for Payer: Hamaspik Choice Inc Medicare	$456.25

ARM 15T ROD 45

Facility

$912.50

Service Code	HCPCS C1713
Hospital Charge Code	64903878
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$958.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$501.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$547.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$524.69
Rate for Payer: EmblemHealth Commercial	$456.25
Rate for Payer: Fidelis Medicare Advantage	$958.12
Rate for Payer: Group Health Inc Commercial	$456.25
Rate for Payer: Group Health Inc Medicare	$319.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.25
Rate for Payer: Hamaspik Choice Inc Medicare	$456.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$593.12

ARM 15T ROD 50

Facility

$912.50

Service Code	HCPCS C1713
Hospital Charge Code	64903877
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$958.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$501.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$547.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$524.69
Rate for Payer: EmblemHealth Commercial	$456.25
Rate for Payer: Fidelis Medicare Advantage	$958.12
Rate for Payer: Group Health Inc Commercial	$456.25
Rate for Payer: Group Health Inc Medicare	$319.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.25
Rate for Payer: Hamaspik Choice Inc Medicare	$456.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$593.12

ARM 15T ROD 50

Facility

$912.50

Service Code	HCPCS C1713
Hospital Charge Code	64903877
Hospital Revenue Code	278
Min. Negotiated Rate	$456.25
Max. Negotiated Rate	$456.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.25
Rate for Payer: Hamaspik Choice Inc Medicare	$456.25

ARMBOARD 3 X 9

Facility

$1.05

Hospital Charge Code	64901934
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.53
Rate for Payer: Aetna Government	$0.53
Rate for Payer: Brighton Health Commercial	$0.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.71
Rate for Payer: Group Health Inc Commercial	$0.53
Rate for Payer: Group Health Inc Medicare	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.53
Rate for Payer: Hamaspik Choice Inc Medicare	$0.53

ARMBOARD,IV,DISP INFANT

Facility

$24.44

Hospital Charge Code	64902449
Hospital Revenue Code	270
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$19.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.22
Rate for Payer: Aetna Government	$12.22
Rate for Payer: Brighton Health Commercial	$18.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.62
Rate for Payer: Group Health Inc Commercial	$12.22
Rate for Payer: Group Health Inc Medicare	$8.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.22
Rate for Payer: Hamaspik Choice Inc Medicare	$12.22

ARMBOARD,IV,DISP INFANT,1X4

Facility

$285.63

Hospital Charge Code	64906213
Hospital Revenue Code	270
Min. Negotiated Rate	$99.97
Max. Negotiated Rate	$228.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$142.82
Rate for Payer: Aetna Government	$142.82
Rate for Payer: Brighton Health Commercial	$214.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$228.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$194.23
Rate for Payer: Group Health Inc Commercial	$142.82
Rate for Payer: Group Health Inc Medicare	$99.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.82
Rate for Payer: Hamaspik Choice Inc Medicare	$142.82

ARMBOARD PEDIATRIC

Facility

$6.79

Hospital Charge Code	64902451
Hospital Revenue Code	270
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$5.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.40
Rate for Payer: Aetna Government	$3.40
Rate for Payer: Brighton Health Commercial	$5.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.62
Rate for Payer: Group Health Inc Commercial	$3.40
Rate for Payer: Group Health Inc Medicare	$2.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.40
Rate for Payer: Hamaspik Choice Inc Medicare	$3.40

ARMBOARD PEDS 2 X 9

Facility

$1.11

Hospital Charge Code	64902260
Hospital Revenue Code	270
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.56
Rate for Payer: Aetna Government	$0.56
Rate for Payer: Brighton Health Commercial	$0.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.75
Rate for Payer: Group Health Inc Commercial	$0.56
Rate for Payer: Group Health Inc Medicare	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56
Rate for Payer: Hamaspik Choice Inc Medicare	$0.56

ARM FLUORO VENT TUBE E 1.14 MM

Facility

$83.00

Service Code	HCPCS L8699
Hospital Charge Code	40004613
Hospital Revenue Code	278
Min. Negotiated Rate	$41.50
Max. Negotiated Rate	$41.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.50
Rate for Payer: Hamaspik Choice Inc Medicare	$41.50

ARM FLUORO VENT TUBE E 1.14 MM

Facility

$83.00

Service Code	HCPCS L8699
Hospital Charge Code	40004613
Hospital Revenue Code	278
Min. Negotiated Rate	$29.05
Max. Negotiated Rate	$87.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.50
Rate for Payer: Aetna Government	$41.50
Rate for Payer: Brighton Health Commercial	$49.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.72
Rate for Payer: EmblemHealth Commercial	$41.50
Rate for Payer: Fidelis Medicare Advantage	$87.15
Rate for Payer: Group Health Inc Commercial	$41.50
Rate for Payer: Group Health Inc Medicare	$29.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.50
Rate for Payer: Hamaspik Choice Inc Medicare	$41.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$53.95

ARM KNIFE

Facility

$41.82

Hospital Charge Code	40200535
Hospital Revenue Code	270
Min. Negotiated Rate	$14.64
Max. Negotiated Rate	$33.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.91
Rate for Payer: Aetna Government	$20.91
Rate for Payer: Brighton Health Commercial	$31.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.44
Rate for Payer: Group Health Inc Commercial	$20.91
Rate for Payer: Group Health Inc Medicare	$14.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.91
Rate for Payer: Hamaspik Choice Inc Medicare	$20.91

ARM SLING

Facility

$28.35

Hospital Charge Code	40200540
Hospital Revenue Code	270
Min. Negotiated Rate	$9.92
Max. Negotiated Rate	$22.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.18
Rate for Payer: Aetna Government	$14.18
Rate for Payer: Brighton Health Commercial	$21.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.28
Rate for Payer: Group Health Inc Commercial	$14.18
Rate for Payer: Group Health Inc Medicare	$9.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.18
Rate for Payer: Hamaspik Choice Inc Medicare	$14.18

ARROW CATHETERIZATION TRAY

Facility

$59.89

Hospital Charge Code	40207595
Hospital Revenue Code	270
Min. Negotiated Rate	$20.96
Max. Negotiated Rate	$47.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.94
Rate for Payer: Aetna Government	$29.94
Rate for Payer: Brighton Health Commercial	$44.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.73
Rate for Payer: Group Health Inc Commercial	$29.94
Rate for Payer: Group Health Inc Medicare	$20.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.94
Rate for Payer: Hamaspik Choice Inc Medicare	$29.94

ARROW CENTRAL VENOUS CATH KIT W/B

Facility

$26.50

Hospital Charge Code	40205565
Hospital Revenue Code	270
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$21.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.25
Rate for Payer: Aetna Government	$13.25
Rate for Payer: Brighton Health Commercial	$19.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.02
Rate for Payer: Group Health Inc Commercial	$13.25
Rate for Payer: Group Health Inc Medicare	$9.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.25
Rate for Payer: Hamaspik Choice Inc Medicare	$13.25

ARROWPERCUTANEOUS SHEATH KIT

Facility

$85.76

Hospital Charge Code	40207617
Hospital Revenue Code	270
Min. Negotiated Rate	$30.02
Max. Negotiated Rate	$68.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$42.88
Rate for Payer: Aetna Government	$42.88
Rate for Payer: Brighton Health Commercial	$64.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$68.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.32
Rate for Payer: Group Health Inc Commercial	$42.88
Rate for Payer: Group Health Inc Medicare	$30.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.88
Rate for Payer: Hamaspik Choice Inc Medicare	$42.88

ARROW RADIAL ARTERY SET

Facility

$25.52

Hospital Charge Code	40207629
Hospital Revenue Code	270
Min. Negotiated Rate	$8.93
Max. Negotiated Rate	$20.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.76
Rate for Payer: Aetna Government	$12.76
Rate for Payer: Brighton Health Commercial	$19.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.35
Rate for Payer: Group Health Inc Commercial	$12.76
Rate for Payer: Group Health Inc Medicare	$8.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.76
Rate for Payer: Hamaspik Choice Inc Medicare	$12.76

A/R SCREW 3.2MM SLEEVE

Facility

$1,184.00

Service Code	HCPCS C1713
Hospital Charge Code	40006150
Hospital Revenue Code	278
Min. Negotiated Rate	$592.00
Max. Negotiated Rate	$592.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$592.00
Rate for Payer: Hamaspik Choice Inc Medicare	$592.00

A/R SCREW 3.2MM SLEEVE

Facility

$1,184.00

Service Code	HCPCS C1713
Hospital Charge Code	40006150
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,243.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$651.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$710.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$592.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$680.80
Rate for Payer: EmblemHealth Commercial	$592.00
Rate for Payer: Fidelis Medicare Advantage	$1,243.20
Rate for Payer: Group Health Inc Commercial	$592.00
Rate for Payer: Group Health Inc Medicare	$414.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$592.00
Rate for Payer: Hamaspik Choice Inc Medicare	$592.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$769.60

A/R SCREW DRILL

Facility

$1,104.00

Service Code	HCPCS C1713
Hospital Charge Code	40006162
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,159.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$607.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$662.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$552.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$634.80
Rate for Payer: EmblemHealth Commercial	$552.00
Rate for Payer: Fidelis Medicare Advantage	$1,159.20
Rate for Payer: Group Health Inc Commercial	$552.00
Rate for Payer: Group Health Inc Medicare	$386.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$552.00
Rate for Payer: Hamaspik Choice Inc Medicare	$552.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$717.60

A/R SCREW DRILL

Facility

$1,104.00

Service Code	HCPCS C1713
Hospital Charge Code	40006162
Hospital Revenue Code	278
Min. Negotiated Rate	$552.00
Max. Negotiated Rate	$552.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$552.00
Rate for Payer: Hamaspik Choice Inc Medicare	$552.00

A/R SCREW REMOVAL TOOL

Facility

$672.00

Service Code	HCPCS C1713
Hospital Charge Code	40006152
Hospital Revenue Code	278
Min. Negotiated Rate	$336.00
Max. Negotiated Rate	$336.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$336.00
Rate for Payer: Hamaspik Choice Inc Medicare	$336.00

A/R SCREW REMOVAL TOOL

Facility

$672.00

Service Code	HCPCS C1713
Hospital Charge Code	40006152
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$705.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$369.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$403.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$336.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$386.40
Rate for Payer: EmblemHealth Commercial	$336.00
Rate for Payer: Fidelis Medicare Advantage	$705.60
Rate for Payer: Group Health Inc Commercial	$336.00
Rate for Payer: Group Health Inc Medicare	$235.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$336.00
Rate for Payer: Hamaspik Choice Inc Medicare	$336.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$436.80

A/R SCREW SHEATH

Facility

$1,136.00

Service Code	HCPCS C1713
Hospital Charge Code	40006148
Hospital Revenue Code	278
Min. Negotiated Rate	$568.00
Max. Negotiated Rate	$568.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$568.00
Rate for Payer: Hamaspik Choice Inc Medicare	$568.00

Know your out-of-pocket cost for care.

All Charges