St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint

Facility

$2,915.00

Service Code	CPT 26070
Hospital Revenue Code	360
Min. Negotiated Rate	$1,301.03
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,858.61
Rate for Payer: Aetna Government	$1,858.61
Rate for Payer: Affinity Essential Plan 1&2	$1,301.03
Rate for Payer: Affinity Essential Plan 3&4	$1,301.03
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,301.03
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,858.61
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	$1,858.61
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,579.82
Rate for Payer: Fidelis Essential Plan QHP	$1,654.16
Rate for Payer: Fidelis Medicare Advantage	$1,858.61
Rate for Payer: Fidelis Qualified Health Plan	$1,654.16
Rate for Payer: Group Health Inc Commercial	$1,858.61
Rate for Payer: Group Health Inc Medicare	$1,858.61
Rate for Payer: Hamaspik Choice Inc Medicare	$1,858.61
Rate for Payer: Healthfirst Medicare Advantage	$1,579.82
Rate for Payer: Healthfirst QHP	$1,858.61
Rate for Payer: Humana Medicare	$1,895.78
Rate for Payer: Senior Whole Health Medicare Advantage	$1,858.61
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$1,858.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,858.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,486.89
Rate for Payer: Wellcare Medicare	$1,765.68

ARTHROWAND CUTTING SABER 30

Facility

$517.50

Hospital Charge Code	64903023
Hospital Revenue Code	270
Min. Negotiated Rate	$181.12
Max. Negotiated Rate	$414.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$284.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$258.75
Rate for Payer: Aetna Government	$258.75
Rate for Payer: Brighton Health Commercial	$388.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$414.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$351.90
Rate for Payer: Group Health Inc Commercial	$258.75
Rate for Payer: Group Health Inc Medicare	$181.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$258.75
Rate for Payer: Hamaspik Choice Inc Medicare	$258.75

ARTHRX 2.5MM DRILL BIT, CALIBRAT

Facility

$85.00

Service Code	HCPCS C1713
Hospital Charge Code	40201575
Hospital Revenue Code	278
Min. Negotiated Rate	$29.75
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$51.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.88
Rate for Payer: EmblemHealth Commercial	$42.50
Rate for Payer: Fidelis Medicare Advantage	$89.25
Rate for Payer: Group Health Inc Commercial	$42.50
Rate for Payer: Group Health Inc Medicare	$29.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.50
Rate for Payer: Hamaspik Choice Inc Medicare	$42.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$55.25

ARTHRX 2.5MM DRILL BIT, CALIBRAT

Facility

$85.00

Service Code	HCPCS C1713
Hospital Charge Code	40201575
Hospital Revenue Code	278
Min. Negotiated Rate	$42.50
Max. Negotiated Rate	$42.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.50
Rate for Payer: Hamaspik Choice Inc Medicare	$42.50

ARTH SUT SD 25 DEG CURVE LT

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	40008263
Hospital Revenue Code	278
Min. Negotiated Rate	$200.00
Max. Negotiated Rate	$200.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00

ARTH SUT SD 25 DEG CURVE LT

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	40008263
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.00
Rate for Payer: EmblemHealth Commercial	$200.00
Rate for Payer: Fidelis Medicare Advantage	$420.00
Rate for Payer: Group Health Inc Commercial	$200.00
Rate for Payer: Group Health Inc Medicare	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.00

ARTHX LOCKNG LATRAL HOOK PLT 3H

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	40201578
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$735.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$420.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.50
Rate for Payer: EmblemHealth Commercial	$350.00
Rate for Payer: Fidelis Medicare Advantage	$735.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$455.00

ARTHX LOCKNG LATRAL HOOK PLT 3H

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	40201578
Hospital Revenue Code	278
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

ARTHX LOCKNG MEDIAL HOOK PLT 3H

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	40201574
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$412.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$412.50
Rate for Payer: Hamaspik Choice Inc Medicare	$412.50

ARTHX LOCKNG MEDIAL HOOK PLT 3H

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	40201574
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$866.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$453.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$495.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$412.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$474.38
Rate for Payer: EmblemHealth Commercial	$412.50
Rate for Payer: Fidelis Medicare Advantage	$866.25
Rate for Payer: Group Health Inc Commercial	$412.50
Rate for Payer: Group Health Inc Medicare	$288.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$412.50
Rate for Payer: Hamaspik Choice Inc Medicare	$412.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$536.25

ARTICAINE-EPINEPHRINE 4 %-1:100000 IJ SOCT [166258]

Facility

$0.66

Service Code	NDC 66312060116
Hospital Charge Code	66312060116
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.33
Rate for Payer: Aetna Government	$0.33
Rate for Payer: Brighton Health Commercial	$0.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.45
Rate for Payer: Group Health Inc Commercial	$0.33
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33
Rate for Payer: Hamaspik Choice Inc Medicare	$0.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.43

ARTICAINE-EPINEPHRINE 4 %-1:200000 IJ SOCT [166257]

Facility

$0.51

Service Code	NDC 45146012002
Hospital Charge Code	45146012002
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.26
Rate for Payer: Aetna Government	$0.26
Rate for Payer: Brighton Health Commercial	$0.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.35
Rate for Payer: Group Health Inc Commercial	$0.26
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.26
Rate for Payer: Hamaspik Choice Inc Medicare	$0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.33

ARTIC SURGACE CRUCIATE RETAINING

Facility

$2,393.60

Service Code	HCPCS C1776
Hospital Charge Code	40200248
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,513.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,316.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,436.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,196.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,376.32
Rate for Payer: EmblemHealth Commercial	$1,196.80
Rate for Payer: Fidelis Medicare Advantage	$2,513.28
Rate for Payer: Group Health Inc Commercial	$1,196.80
Rate for Payer: Group Health Inc Medicare	$837.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,196.80
Rate for Payer: Hamaspik Choice Inc Medicare	$1,196.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,555.84

ARTIC SURGACE CRUCIATE RETAINING

Facility

$2,393.60

Service Code	HCPCS C1776
Hospital Charge Code	40200248
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.80
Max. Negotiated Rate	$1,196.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,196.80
Rate for Payer: Hamaspik Choice Inc Medicare	$1,196.80

ARTICULAR SURGACE CR GREEN C-H

Facility

$3,354.10

Service Code	HCPCS C1776
Hospital Charge Code	40202088
Hospital Revenue Code	278
Min. Negotiated Rate	$1,677.05
Max. Negotiated Rate	$1,677.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,677.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1,677.05

ARTICULAR SURGACE CR GREEN C-H

Facility

$3,354.10

Service Code	HCPCS C1776
Hospital Charge Code	40202088
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,521.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,844.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,012.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,677.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,928.61
Rate for Payer: EmblemHealth Commercial	$1,677.05
Rate for Payer: Fidelis Medicare Advantage	$3,521.80
Rate for Payer: Group Health Inc Commercial	$1,677.05
Rate for Payer: Group Health Inc Medicare	$1,173.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,677.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1,677.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,180.16

ARTICULAR SURGACE CR YELLOW C-H

Facility

$3,354.10

Hospital Charge Code	40202091
Hospital Revenue Code	270
Min. Negotiated Rate	$1,173.94
Max. Negotiated Rate	$2,683.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,844.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,677.05
Rate for Payer: Aetna Government	$1,677.05
Rate for Payer: Brighton Health Commercial	$2,515.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,683.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,280.79
Rate for Payer: Group Health Inc Commercial	$1,677.05
Rate for Payer: Group Health Inc Medicare	$1,173.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,677.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1,677.05

ARTICUL/EZE BALL 28

Facility

$2,957.50

Service Code	HCPCS C1713
Hospital Charge Code	64903612
Hospital Revenue Code	278
Min. Negotiated Rate	$1,478.75
Max. Negotiated Rate	$1,478.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,478.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,478.75

ARTICUL/EZE BALL 28

Facility

$2,957.50

Service Code	HCPCS C1713
Hospital Charge Code	64903612
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,105.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,626.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,774.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,478.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,700.56
Rate for Payer: EmblemHealth Commercial	$1,478.75
Rate for Payer: Fidelis Medicare Advantage	$3,105.38
Rate for Payer: Group Health Inc Commercial	$1,478.75
Rate for Payer: Group Health Inc Medicare	$1,035.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,478.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,478.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,922.38

ARTICUL/EZE BALL 28 5 BR

Facility

$2,402.00

Service Code	HCPCS C1776
Hospital Charge Code	40005146
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,522.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,321.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,441.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,201.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,381.15
Rate for Payer: EmblemHealth Commercial	$1,201.00
Rate for Payer: Fidelis Medicare Advantage	$2,522.10
Rate for Payer: Group Health Inc Commercial	$1,201.00
Rate for Payer: Group Health Inc Medicare	$840.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,201.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,201.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,561.30

ARTICUL/EZE BALL 28 5 BR

Facility

$2,402.00

Service Code	HCPCS C1776
Hospital Charge Code	40005146
Hospital Revenue Code	278
Min. Negotiated Rate	$1,201.00
Max. Negotiated Rate	$1,201.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,201.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,201.00

ARTICUL/EZE BALL 28 5 BR

Facility

$3,002.50

Service Code	HCPCS C1713
Hospital Charge Code	64905205
Hospital Revenue Code	278
Min. Negotiated Rate	$1,501.25
Max. Negotiated Rate	$1,501.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,501.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,501.25

ARTICUL/EZE BALL 28 5 BR

Facility

$3,002.50

Service Code	HCPCS C1713
Hospital Charge Code	64905205
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,152.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,651.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,801.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,501.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,726.44
Rate for Payer: EmblemHealth Commercial	$1,501.25
Rate for Payer: Fidelis Medicare Advantage	$3,152.62
Rate for Payer: Group Health Inc Commercial	$1,501.25
Rate for Payer: Group Health Inc Medicare	$1,050.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,501.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,501.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,951.62

ARTIFICIAL TEARS 1.4% OPHTHALMIC SOLN

Facility

$3.00

Hospital Charge Code	41650165
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

ARTIFICIAL TEARS 1.4% OPHTHALMIC SOLN

Facility

$3.00

Hospital Charge Code	41640165
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

Know your out-of-pocket cost for care.

All Charges