St. Barnabas Hospital

All Charges

Charge

Type

Price

STABILIZER EZ

Facility OP

$42.50

Hospital Charge Code	64904877
Hospital Revenue Code	270
Min. Negotiated Rate	$14.88
Max. Negotiated Rate	$34.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.25
Rate for Payer: Aetna Government	$21.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.90
Rate for Payer: Group Health Inc Commercial	$21.25
Rate for Payer: Group Health Inc Medicare	$14.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.25
Rate for Payer: Hamaspik Choice Inc Medicare	$21.25

STABLIZER SHOULDER

Facility OP

$170.00

Hospital Charge Code	64903497
Hospital Revenue Code	270
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$136.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$85.00
Rate for Payer: Aetna Government	$85.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.60
Rate for Payer: Group Health Inc Commercial	$85.00
Rate for Payer: Group Health Inc Medicare	$59.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00

STAGGERED SPONDAIC WORD TEST

Facility OP

$419.03

Service Code	HCPCS 92572
Hospital Charge Code	42004507
Hospital Revenue Code	471
Min. Negotiated Rate	$52.45
Max. Negotiated Rate	$335.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.64
Rate for Payer: Aetna Government	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.94
Rate for Payer: Elderplan Medicare Advantage	$180.64
Rate for Payer: EmblemHealth Commercial	$180.64
Rate for Payer: Fidelis CHP/HARP/Medicaid	$52.45
Rate for Payer: Fidelis Essential Plan Aliesa	$153.54
Rate for Payer: Fidelis Essential Plan QHP	$160.77
Rate for Payer: Fidelis Medicare Advantage	$180.64
Rate for Payer: Fidelis Qualified Health Plan	$160.77
Rate for Payer: Group Health Inc Commercial	$180.64
Rate for Payer: Group Health Inc Medicare	$180.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.52
Rate for Payer: Hamaspik Choice Inc Medicare	$180.64
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$58.28
Rate for Payer: Healthfirst Medicare Advantage	$153.54
Rate for Payer: Healthfirst QHP	$180.64
Rate for Payer: Senior Whole Health Medicare Advantage	$180.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$144.51
Rate for Payer: Wellcare Medicare	$171.61

STAGING LAPAROTOMY

Facility OP

$3,077.68

Service Code	HCPCS 58960
Hospital Charge Code	40011060
Hospital Revenue Code	360
Min. Negotiated Rate	$1,077.19
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,692.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,247.93
Rate for Payer: Aetna Government	$1,247.93
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: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,113.90
Rate for Payer: Group Health Inc Commercial	$1,538.84
Rate for Payer: Group Health Inc Medicare	$1,077.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,538.84
Rate for Payer: Hamaspik Choice Inc Medicare	$1,538.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,237.67

STAGRAFT DBM 10CC PUTTY

Facility IP

$3,362.50

Service Code	HCPCS C1713
Hospital Charge Code	64902994
Hospital Revenue Code	278
Min. Negotiated Rate	$1,681.25
Max. Negotiated Rate	$1,681.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,681.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,681.25

STAGRAFT DBM 10CC PUTTY

Facility OP

$3,362.50

Service Code	HCPCS C1713
Hospital Charge Code	64902994
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,530.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,849.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,681.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,933.44
Rate for Payer: Fidelis Medicare Advantage	$3,530.62
Rate for Payer: Group Health Inc Commercial	$1,681.25
Rate for Payer: Group Health Inc Medicare	$1,176.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,681.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,681.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,185.62

STAMAHESIVE

Facility OP

$25.52

Hospital Charge Code	40207627
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: 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

STANDARD HARD PADDLES

Facility OP

$1,042.80

Hospital Charge Code	64902836
Hospital Revenue Code	270
Min. Negotiated Rate	$364.98
Max. Negotiated Rate	$834.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$573.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$521.40
Rate for Payer: Aetna Government	$521.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$834.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$709.10
Rate for Payer: Group Health Inc Commercial	$521.40
Rate for Payer: Group Health Inc Medicare	$364.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$521.40
Rate for Payer: Hamaspik Choice Inc Medicare	$521.40

STANDARD PEG KIT PUSH 20FR

Facility OP

$380.00

Hospital Charge Code	40209780
Hospital Revenue Code	270
Min. Negotiated Rate	$133.00
Max. Negotiated Rate	$304.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$209.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$190.00
Rate for Payer: Aetna Government	$190.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$304.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$258.40
Rate for Payer: Group Health Inc Commercial	$190.00
Rate for Payer: Group Health Inc Medicare	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00

STANDR POLY PATELLA SZ32 8.5MM

Facility IP

$2,269.50

Service Code	HCPCS C1776
Hospital Charge Code	40209933
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.75
Max. Negotiated Rate	$1,134.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,134.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,134.75

STANDR POLY PATELLA SZ32 8.5MM

Facility OP

$2,269.50

Service Code	HCPCS C1776
Hospital Charge Code	40209933
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,382.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,248.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,134.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,304.96
Rate for Payer: Fidelis Medicare Advantage	$2,382.98
Rate for Payer: Group Health Inc Commercial	$1,134.75
Rate for Payer: Group Health Inc Medicare	$794.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,134.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,134.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,475.18

STAPLE 16MM STAPIX

Facility IP

$4,170.00

Service Code	HCPCS C1713
Hospital Charge Code	40006562
Hospital Revenue Code	278
Min. Negotiated Rate	$2,085.00
Max. Negotiated Rate	$2,085.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,085.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,085.00

STAPLE 16MM STAPIX

Facility OP

$4,170.00

Service Code	HCPCS C1713
Hospital Charge Code	40006562
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,378.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,293.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,085.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,397.75
Rate for Payer: Fidelis Medicare Advantage	$4,378.50
Rate for Payer: Group Health Inc Commercial	$2,085.00
Rate for Payer: Group Health Inc Medicare	$1,459.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,085.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,085.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,710.50

STAPLE BARBED

Facility IP

$70.00

Service Code	HCPCS C1713
Hospital Charge Code	40202127
Hospital Revenue Code	278
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.00
Rate for Payer: Hamaspik Choice Inc Medicare	$35.00

STAPLE BARBED

Facility OP

$70.00

Service Code	HCPCS C1713
Hospital Charge Code	40202127
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.25
Rate for Payer: Fidelis Medicare Advantage	$73.50
Rate for Payer: Group Health Inc Commercial	$35.00
Rate for Payer: Group Health Inc Medicare	$24.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.00
Rate for Payer: Hamaspik Choice Inc Medicare	$35.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$45.50

STAPLE BONE FIX LO PRO

Facility IP

$2.50

Service Code	HCPCS C1713
Hospital Charge Code	64907344
Hospital Revenue Code	278
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25

STAPLE BONE FIX LO PRO

Facility OP

$2.50

Service Code	HCPCS C1713
Hospital Charge Code	64907344
Hospital Revenue Code	278
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.44
Rate for Payer: Fidelis Medicare Advantage	$2.62
Rate for Payer: Group Health Inc Commercial	$1.25
Rate for Payer: Group Health Inc Medicare	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.62

STAPLE NITINOL

Facility OP

$6,255.00

Service Code	HCPCS C1889
Hospital Charge Code	64907484
Hospital Revenue Code	278
Min. Negotiated Rate	$2,189.25
Max. Negotiated Rate	$6,567.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,440.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,127.50
Rate for Payer: Aetna Government	$3,127.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,127.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,596.62
Rate for Payer: Fidelis Medicare Advantage	$6,567.75
Rate for Payer: Group Health Inc Commercial	$3,127.50
Rate for Payer: Group Health Inc Medicare	$2,189.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,127.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,127.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,065.75

STAPLE NITINOL

Facility IP

$6,255.00

Service Code	HCPCS C1889
Hospital Charge Code	64907484
Hospital Revenue Code	278
Min. Negotiated Rate	$3,127.50
Max. Negotiated Rate	$3,127.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,127.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,127.50

STAPLER 25MM DIAMETER

Facility OP

$802.03

Hospital Charge Code	64905134
Hospital Revenue Code	270
Min. Negotiated Rate	$280.71
Max. Negotiated Rate	$641.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$441.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$401.02
Rate for Payer: Aetna Government	$401.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$641.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$545.38
Rate for Payer: Group Health Inc Commercial	$401.02
Rate for Payer: Group Health Inc Medicare	$280.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$401.02
Rate for Payer: Hamaspik Choice Inc Medicare	$401.02

STAPLER CONTOUR CURVED CUTTER

Facility OP

$1,124.63

Hospital Charge Code	64905450
Hospital Revenue Code	270
Min. Negotiated Rate	$393.62
Max. Negotiated Rate	$899.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$618.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$562.32
Rate for Payer: Aetna Government	$562.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$899.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$764.75
Rate for Payer: Group Health Inc Commercial	$562.32
Rate for Payer: Group Health Inc Medicare	$393.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$562.32
Rate for Payer: Hamaspik Choice Inc Medicare	$562.32

STAPLER DST GIA C

Facility OP

$345.60

Hospital Charge Code	64907040
Hospital Revenue Code	270
Min. Negotiated Rate	$120.96
Max. Negotiated Rate	$276.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$172.80
Rate for Payer: Aetna Government	$172.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$276.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$235.01
Rate for Payer: Group Health Inc Commercial	$172.80
Rate for Payer: Group Health Inc Medicare	$120.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.80
Rate for Payer: Hamaspik Choice Inc Medicare	$172.80

STAPLER EEA CIRCULAR

Facility OP

$896.41

Hospital Charge Code	64904648
Hospital Revenue Code	270
Min. Negotiated Rate	$313.74
Max. Negotiated Rate	$717.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$493.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$448.20
Rate for Payer: Aetna Government	$448.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$717.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$609.56
Rate for Payer: Group Health Inc Commercial	$448.20
Rate for Payer: Group Health Inc Medicare	$313.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$448.20
Rate for Payer: Hamaspik Choice Inc Medicare	$448.20

STAPLER EEA CIRCULAR (EEA28)

Facility OP

$1,946.70

Hospital Charge Code	40205111
Hospital Revenue Code	270
Min. Negotiated Rate	$681.34
Max. Negotiated Rate	$1,557.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,070.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$973.35
Rate for Payer: Aetna Government	$973.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,557.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,323.76
Rate for Payer: Group Health Inc Commercial	$973.35
Rate for Payer: Group Health Inc Medicare	$681.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$973.35
Rate for Payer: Hamaspik Choice Inc Medicare	$973.35

STAPLE RELOAD 45MM (SIG45CTAMT)

Facility OP

$1,119.58

Hospital Charge Code	64906557
Hospital Revenue Code	279
Min. Negotiated Rate	$391.85
Max. Negotiated Rate	$895.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$615.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$559.79
Rate for Payer: Aetna Government	$559.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$895.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$761.31
Rate for Payer: Group Health Inc Commercial	$559.79
Rate for Payer: Group Health Inc Medicare	$391.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$559.79
Rate for Payer: Hamaspik Choice Inc Medicare	$559.79

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