St. Barnabas Hospital

All Charges

Charge

Type

Price

STRY VITOSS BIM 10CC

Facility OP

$7,472.66

Service Code	HCPCS C1713
Hospital Charge Code	40003444
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,846.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,109.96
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	$3,736.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,296.78
Rate for Payer: Fidelis Medicare Advantage	$7,846.29
Rate for Payer: Group Health Inc Commercial	$3,736.33
Rate for Payer: Group Health Inc Medicare	$2,615.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,736.33
Rate for Payer: Hamaspik Choice Inc Medicare	$3,736.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,857.23

STRY VITOSS BIMODAL 2.5CC

Facility IP

$4,009.72

Service Code	HCPCS C1713
Hospital Charge Code	40204252
Hospital Revenue Code	278
Min. Negotiated Rate	$2,004.86
Max. Negotiated Rate	$2,004.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,004.86
Rate for Payer: Hamaspik Choice Inc Medicare	$2,004.86

STRY VITOSS BIMODAL 2.5CC

Facility OP

$4,009.72

Service Code	HCPCS C1713
Hospital Charge Code	40204252
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,210.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,205.35
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	$2,004.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,305.59
Rate for Payer: Fidelis Medicare Advantage	$4,210.21
Rate for Payer: Group Health Inc Commercial	$2,004.86
Rate for Payer: Group Health Inc Medicare	$1,403.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,004.86
Rate for Payer: Hamaspik Choice Inc Medicare	$2,004.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,606.32

STRY XIA3 PA SCR 6.0X35MM

Facility OP

$4,057.02

Service Code	HCPCS C1713
Hospital Charge Code	40003440
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,259.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,231.36
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	$2,028.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,332.79
Rate for Payer: Fidelis Medicare Advantage	$4,259.87
Rate for Payer: Group Health Inc Commercial	$2,028.51
Rate for Payer: Group Health Inc Medicare	$1,419.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,028.51
Rate for Payer: Hamaspik Choice Inc Medicare	$2,028.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,637.06

STRY XIA3 PA SCR 6.0X35MM

Facility IP

$4,057.02

Service Code	HCPCS C1713
Hospital Charge Code	40003440
Hospital Revenue Code	278
Min. Negotiated Rate	$2,028.51
Max. Negotiated Rate	$2,028.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,028.51
Rate for Payer: Hamaspik Choice Inc Medicare	$2,028.51

STRY XIA ROD 480X6MM

Facility OP

$1,508.72

Service Code	HCPCS C1713
Hospital Charge Code	40008318
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,584.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$829.80
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	$754.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$867.51
Rate for Payer: Fidelis Medicare Advantage	$1,584.16
Rate for Payer: Group Health Inc Commercial	$754.36
Rate for Payer: Group Health Inc Medicare	$528.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$754.36
Rate for Payer: Hamaspik Choice Inc Medicare	$754.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$980.67

STRY XIA ROD 480X6MM

Facility IP

$1,508.72

Service Code	HCPCS C1713
Hospital Charge Code	40008318
Hospital Revenue Code	278
Min. Negotiated Rate	$754.36
Max. Negotiated Rate	$754.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$754.36
Rate for Payer: Hamaspik Choice Inc Medicare	$754.36

STUDIES W/&W/O BRONCHDIALTOR

Facility OP

$766.58

Service Code	HCPCS 94060 TC
Hospital Charge Code	40401500
Hospital Revenue Code	460
Min. Negotiated Rate	$31.75
Max. Negotiated Rate	$613.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$383.29
Rate for Payer: Aetna Government	$383.29
Rate for Payer: Cash Price	$362.98
Rate for Payer: Cash Price	$362.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$613.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$521.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31.75
Rate for Payer: Group Health Inc Commercial	$383.29
Rate for Payer: Group Health Inc Medicare	$268.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.29
Rate for Payer: Hamaspik Choice Inc Medicare	$383.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35.28

STUDY-HALOPERIDL/METOCLPRM INJ

Facility OP

$0.01

Service Code	HCPCS J3490 Q0
Hospital Charge Code	41650239
Hospital Revenue Code	636
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

STUDY-HALOPERIDL/METOCLPRM INJ

Facility IP

$0.01

Service Code	HCPCS J3490 Q0
Hospital Charge Code	41650239
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

STUDY-HALOPERIDL/METOCLPRM INJ

Facility IP

$0.01

Service Code	HCPCS J3490 Q0
Hospital Charge Code	41640239
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

STUDY-HALOPERIDL/METOCLPRM INJ

Facility OP

$0.01

Service Code	HCPCS J3490 Q0
Hospital Charge Code	41640239
Hospital Revenue Code	636
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

STYKER LOCKING 2.7MMX12MM 656312

Facility IP

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40005354
Hospital Revenue Code	278
Min. Negotiated Rate	$281.00
Max. Negotiated Rate	$281.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00

STYKER LOCKING 2.7MMX12MM 656312

Facility OP

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40005354
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$590.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.10
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	$281.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.15
Rate for Payer: Fidelis Medicare Advantage	$590.10
Rate for Payer: Group Health Inc Commercial	$281.00
Rate for Payer: Group Health Inc Medicare	$196.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$365.30

STYKER LOCKING 2.7MMX14MM 656314

Facility IP

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40005352
Hospital Revenue Code	278
Min. Negotiated Rate	$281.00
Max. Negotiated Rate	$281.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00

STYKER LOCKING 2.7MMX14MM 656314

Facility OP

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40005352
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$590.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.10
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	$281.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.15
Rate for Payer: Fidelis Medicare Advantage	$590.10
Rate for Payer: Group Health Inc Commercial	$281.00
Rate for Payer: Group Health Inc Medicare	$196.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$365.30

STYKER SCREW 3.5 X 14 MM

Facility OP

$2,160.00

Service Code	HCPCS C1776
Hospital Charge Code	40205006
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,268.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,188.00
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	$1,080.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,242.00
Rate for Payer: Fidelis Medicare Advantage	$2,268.00
Rate for Payer: Group Health Inc Commercial	$1,080.00
Rate for Payer: Group Health Inc Medicare	$756.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,080.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,080.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,404.00

STYKER SCREW 3.5 X 14 MM

Facility IP

$2,160.00

Service Code	HCPCS C1776
Hospital Charge Code	40205006
Hospital Revenue Code	278
Min. Negotiated Rate	$1,080.00
Max. Negotiated Rate	$1,080.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,080.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,080.00

STYKER SCREW LAG 6.5X90MM

Facility IP

$343.00

Service Code	HCPCS C1713
Hospital Charge Code	40205083
Hospital Revenue Code	278
Min. Negotiated Rate	$171.50
Max. Negotiated Rate	$171.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.50
Rate for Payer: Hamaspik Choice Inc Medicare	$171.50

STYKER SCREW LAG 6.5X90MM

Facility OP

$343.00

Service Code	HCPCS C1713
Hospital Charge Code	40205083
Hospital Revenue Code	278
Min. Negotiated Rate	$120.05
Max. Negotiated Rate	$360.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$188.65
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	$171.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$197.22
Rate for Payer: Fidelis Medicare Advantage	$360.15
Rate for Payer: Group Health Inc Commercial	$171.50
Rate for Payer: Group Health Inc Medicare	$120.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.50
Rate for Payer: Hamaspik Choice Inc Medicare	$171.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$222.95

STYKER SCREW LOCKING 2.7

Facility OP

$243.60

Service Code	HCPCS C1713
Hospital Charge Code	40205547
Hospital Revenue Code	278
Min. Negotiated Rate	$85.26
Max. Negotiated Rate	$255.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.98
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	$121.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.07
Rate for Payer: Fidelis Medicare Advantage	$255.78
Rate for Payer: Group Health Inc Commercial	$121.80
Rate for Payer: Group Health Inc Medicare	$85.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.80
Rate for Payer: Hamaspik Choice Inc Medicare	$121.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$158.34

STYKER SCREW LOCKING 2.7

Facility IP

$243.60

Service Code	HCPCS C1713
Hospital Charge Code	40205547
Hospital Revenue Code	278
Min. Negotiated Rate	$121.80
Max. Negotiated Rate	$121.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.80
Rate for Payer: Hamaspik Choice Inc Medicare	$121.80

STYLET, 59CM TAPERED SOFT

Facility OP

$125.00

Hospital Charge Code	64902644
Hospital Revenue Code	270
Min. Negotiated Rate	$43.75
Max. Negotiated Rate	$100.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.50
Rate for Payer: Aetna Government	$62.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.00
Rate for Payer: Group Health Inc Commercial	$62.50
Rate for Payer: Group Health Inc Medicare	$43.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.50
Rate for Payer: Hamaspik Choice Inc Medicare	$62.50

STYLET ENDOTRACH NEONAT SLICK 6FR

Facility OP

$6.75

Hospital Charge Code	64902431
Hospital Revenue Code	270
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.38
Rate for Payer: Aetna Government	$3.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.59
Rate for Payer: Group Health Inc Commercial	$3.38
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.38
Rate for Payer: Hamaspik Choice Inc Medicare	$3.38

STYLET FLEXI-SLIP 14FR

Facility OP

$4.60

Hospital Charge Code	64904081
Hospital Revenue Code	270
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$3.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.30
Rate for Payer: Aetna Government	$2.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.13
Rate for Payer: Group Health Inc Commercial	$2.30
Rate for Payer: Group Health Inc Medicare	$1.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.30
Rate for Payer: Hamaspik Choice Inc Medicare	$2.30

Price Transparency.

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