St. Barnabas Hospital

All Charges

Charge

Type

Price

STERILE WATER FOR INJECTION 100 ML VIAL

Facility OP

$5.15

Service Code	HCPCS A4216
Hospital Charge Code	41652608
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.83
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	$4.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.50
Rate for Payer: Group Health Inc Commercial	$2.58
Rate for Payer: Group Health Inc Medicare	$1.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.58
Rate for Payer: Hamaspik Choice Inc Medicare	$2.58

STERILE WATER FOR INJECTION 20 ML

Facility OP

$2.20

Service Code	HCPCS A4216
Hospital Charge Code	41644158
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$1.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.21
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	$1.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.50
Rate for Payer: Group Health Inc Commercial	$1.10
Rate for Payer: Group Health Inc Medicare	$0.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1.10

STERILE WATER FOR INJECTION 20 ML

Facility OP

$2.20

Service Code	HCPCS A4216
Hospital Charge Code	41654158
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$1.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.21
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	$1.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.50
Rate for Payer: Group Health Inc Commercial	$1.10
Rate for Payer: Group Health Inc Medicare	$0.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1.10

STERILE WATER FOR INJECTION INFUSION 100

Facility OP

$2.00

Service Code	HCPCS A4217
Hospital Charge Code	41642607
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.62
Rate for Payer: Aetna Government	$1.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

STERILE WATER FOR INJECTION INFUSION 100

Facility OP

$2.00

Service Code	HCPCS A4217
Hospital Charge Code	41652607
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.62
Rate for Payer: Aetna Government	$1.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

STERILE WATER FOR IRRIGATION SOLUTION 10

Facility OP

$2.00

Service Code	HCPCS A4217
Hospital Charge Code	41652509
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.62
Rate for Payer: Aetna Government	$1.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

STERILE WATER FOR IRRIGATION SOLUTION 10

Facility OP

$2.00

Service Code	HCPCS A4217
Hospital Charge Code	41642509
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.62
Rate for Payer: Aetna Government	$1.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

STERIL WATR BLADR IRRG-3000CC

Facility OP

$19.49

Hospital Charge Code	40507117
Hospital Revenue Code	260
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$15.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.74
Rate for Payer: Aetna Government	$9.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.25
Rate for Payer: Group Health Inc Commercial	$9.74
Rate for Payer: Group Health Inc Medicare	$6.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.74
Rate for Payer: Hamaspik Choice Inc Medicare	$9.74

Steri Strip

Facility OP

$1.77

Hospital Charge Code	40205733
Hospital Revenue Code	270
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$1.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.89
Rate for Payer: Aetna Government	$0.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.20
Rate for Payer: Group Health Inc Commercial	$0.89
Rate for Payer: Group Health Inc Medicare	$0.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.89
Rate for Payer: Hamaspik Choice Inc Medicare	$0.89

STERITITE CONTAINER W/ LID

Facility OP

$1,275.75

Hospital Charge Code	64903486
Hospital Revenue Code	270
Min. Negotiated Rate	$446.51
Max. Negotiated Rate	$1,020.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$637.88
Rate for Payer: Aetna Government	$637.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,020.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$867.51
Rate for Payer: Group Health Inc Commercial	$637.88
Rate for Payer: Group Health Inc Medicare	$446.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$637.88
Rate for Payer: Hamaspik Choice Inc Medicare	$637.88

STERITITE CONTAINER WLID

Facility OP

$1,076.25

Hospital Charge Code	64903478
Hospital Revenue Code	270
Min. Negotiated Rate	$376.69
Max. Negotiated Rate	$861.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$591.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$538.12
Rate for Payer: Aetna Government	$538.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$861.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$731.85
Rate for Payer: Group Health Inc Commercial	$538.12
Rate for Payer: Group Health Inc Medicare	$376.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$538.12
Rate for Payer: Hamaspik Choice Inc Medicare	$538.12

STERITITE CONT PERF BOTTLE W/LID

Facility OP

$1,219.05

Hospital Charge Code	64903462
Hospital Revenue Code	270
Min. Negotiated Rate	$426.67
Max. Negotiated Rate	$975.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$670.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$609.52
Rate for Payer: Aetna Government	$609.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$975.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$828.95
Rate for Payer: Group Health Inc Commercial	$609.52
Rate for Payer: Group Health Inc Medicare	$426.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$609.52
Rate for Payer: Hamaspik Choice Inc Medicare	$609.52

STERITITE UNIVER CONTA W/LID

Facility OP

$1,429.75

Hospital Charge Code	64903472
Hospital Revenue Code	270
Min. Negotiated Rate	$500.41
Max. Negotiated Rate	$1,143.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$786.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$714.88
Rate for Payer: Aetna Government	$714.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,143.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$972.23
Rate for Payer: Group Health Inc Commercial	$714.88
Rate for Payer: Group Health Inc Medicare	$500.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$714.88
Rate for Payer: Hamaspik Choice Inc Medicare	$714.88

STERNAL BIOPSY

Facility OP

$4,157.25

Service Code	HCPCS 20220
Hospital Charge Code	40011110
Hospital Revenue Code	360
Min. Negotiated Rate	$93.56
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,874.89
Rate for Payer: Aetna Government	$1,874.89
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,874.89
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	$1,874.89
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$93.56
Rate for Payer: Fidelis Essential Plan Aliesa	$1,593.66
Rate for Payer: Fidelis Essential Plan QHP	$1,668.65
Rate for Payer: Fidelis Medicare Advantage	$1,874.89
Rate for Payer: Fidelis Qualified Health Plan	$1,668.65
Rate for Payer: Group Health Inc Commercial	$1,874.89
Rate for Payer: Group Health Inc Medicare	$1,874.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,874.89
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$103.96
Rate for Payer: Healthfirst Medicare Advantage	$1,593.66
Rate for Payer: Healthfirst QHP	$1,874.89
Rate for Payer: Senior Whole Health Medicare Advantage	$1,874.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,874.89
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,499.91
Rate for Payer: Wellcare Medicare	$1,781.15

STERNAL PUNC(BONE MAROW TRAY)

Facility OP

$65.21

Hospital Charge Code	40205740
Hospital Revenue Code	270
Min. Negotiated Rate	$22.82
Max. Negotiated Rate	$52.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.60
Rate for Payer: Aetna Government	$32.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.34
Rate for Payer: Group Health Inc Commercial	$32.60
Rate for Payer: Group Health Inc Medicare	$22.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.60
Rate for Payer: Hamaspik Choice Inc Medicare	$32.60

STERNOTOMY

Facility OP

$1,995.60

Service Code	HCPCS 21750
Hospital Charge Code	40024322
Hospital Revenue Code	360
Min. Negotiated Rate	$698.46
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,097.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$716.83
Rate for Payer: Aetna Government	$716.83
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	$776.87
Rate for Payer: Group Health Inc Commercial	$997.80
Rate for Payer: Group Health Inc Medicare	$698.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$997.80
Rate for Payer: Hamaspik Choice Inc Medicare	$997.80
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$863.19

STERNUM SAW BLADES 32MM

Facility OP

$2.99

Hospital Charge Code	64905766
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.03
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

STERRAD TYVEK ROLL

Facility OP

$291.90

Hospital Charge Code	64905295
Hospital Revenue Code	270
Min. Negotiated Rate	$102.16
Max. Negotiated Rate	$233.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$160.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$145.95
Rate for Payer: Aetna Government	$145.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$233.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$198.49
Rate for Payer: Group Health Inc Commercial	$145.95
Rate for Payer: Group Health Inc Medicare	$102.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$145.95
Rate for Payer: Hamaspik Choice Inc Medicare	$145.95

Stethoscope

Facility OP

$25.87

Hospital Charge Code	40205737
Hospital Revenue Code	270
Min. Negotiated Rate	$9.05
Max. Negotiated Rate	$20.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.94
Rate for Payer: Aetna Government	$12.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.59
Rate for Payer: Group Health Inc Commercial	$12.94
Rate for Payer: Group Health Inc Medicare	$9.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.94
Rate for Payer: Hamaspik Choice Inc Medicare	$12.94

STETHOSCOPE

Facility OP

$22.32

Hospital Charge Code	40204849
Hospital Revenue Code	270
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$17.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.16
Rate for Payer: Aetna Government	$11.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.18
Rate for Payer: Group Health Inc Commercial	$11.16
Rate for Payer: Group Health Inc Medicare	$7.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.16
Rate for Payer: Hamaspik Choice Inc Medicare	$11.16

STETHOSCOPE ESOPHAGEAL 18FR 400

Facility OP

$5.63

Hospital Charge Code	64903398
Hospital Revenue Code	270
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$4.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.82
Rate for Payer: Aetna Government	$2.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.83
Rate for Payer: Group Health Inc Commercial	$2.82
Rate for Payer: Group Health Inc Medicare	$1.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.82
Rate for Payer: Hamaspik Choice Inc Medicare	$2.82

STETHOSCOPE ESOPHAGEAL 9FR 400

Facility OP

$20.00

Hospital Charge Code	64903400
Hospital Revenue Code	270
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$16.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.00
Rate for Payer: Aetna Government	$10.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.60
Rate for Payer: Group Health Inc Commercial	$10.00
Rate for Payer: Group Health Inc Medicare	$7.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.00
Rate for Payer: Hamaspik Choice Inc Medicare	$10.00

STETHOSCOPE,SINGLE HD BLUE

Facility OP

$3.75

Hospital Charge Code	64901665
Hospital Revenue Code	270
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$3.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.88
Rate for Payer: Aetna Government	$1.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.55
Rate for Payer: Group Health Inc Commercial	$1.88
Rate for Payer: Group Health Inc Medicare	$1.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.88
Rate for Payer: Hamaspik Choice Inc Medicare	$1.88

STILLE-LUER RONGEUR 10 (25.4)

Facility OP

$607.18

Hospital Charge Code	64905653
Hospital Revenue Code	270
Min. Negotiated Rate	$212.51
Max. Negotiated Rate	$485.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$333.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$303.59
Rate for Payer: Aetna Government	$303.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$485.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$412.88
Rate for Payer: Group Health Inc Commercial	$303.59
Rate for Payer: Group Health Inc Medicare	$212.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$303.59
Rate for Payer: Hamaspik Choice Inc Medicare	$303.59

STIMU BIOCOMP KEEL ST5 5NL 20CC

Facility IP

$3,390.00

Service Code	HCPCS C1713
Hospital Charge Code	40005245
Hospital Revenue Code	278
Min. Negotiated Rate	$1,695.00
Max. Negotiated Rate	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,695.00

Price Transparency.

All Charges