St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

REAGENT DSC PR

Facility

$685.95

Service Code	HCPCS C1713
Hospital Charge Code	64902653
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$720.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$377.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$411.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$342.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$394.42
Rate for Payer: EmblemHealth Commercial	$342.98
Rate for Payer: Fidelis Medicare Advantage	$720.25
Rate for Payer: Group Health Inc Commercial	$342.98
Rate for Payer: Group Health Inc Medicare	$240.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$342.98
Rate for Payer: Hamaspik Choice Inc Medicare	$342.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$445.87

REAGENT DSC PR

Facility

$685.95

Service Code	HCPCS C1713
Hospital Charge Code	64902653
Hospital Revenue Code	278
Min. Negotiated Rate	$342.98
Max. Negotiated Rate	$342.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$342.98
Rate for Payer: Hamaspik Choice Inc Medicare	$342.98

REAGENT STRIP LABSTIX AMES

Facility

$0.84

Hospital Charge Code	64901951
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Brighton Health Commercial	$0.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42

REAMER 8 X 510

Facility

$871.25

Hospital Charge Code	64904817
Hospital Revenue Code	270
Min. Negotiated Rate	$304.94
Max. Negotiated Rate	$697.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$479.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$435.62
Rate for Payer: Aetna Government	$435.62
Rate for Payer: Brighton Health Commercial	$653.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$697.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$592.45
Rate for Payer: Group Health Inc Commercial	$435.62
Rate for Payer: Group Health Inc Medicare	$304.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$435.62
Rate for Payer: Hamaspik Choice Inc Medicare	$435.62

REAMER CANNUL 3.5 17MM FIXOS

Facility

$785.00

Hospital Charge Code	64906035
Hospital Revenue Code	270
Min. Negotiated Rate	$274.75
Max. Negotiated Rate	$628.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$431.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$392.50
Rate for Payer: Aetna Government	$392.50
Rate for Payer: Brighton Health Commercial	$588.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$628.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$533.80
Rate for Payer: Group Health Inc Commercial	$392.50
Rate for Payer: Group Health Inc Medicare	$274.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$392.50
Rate for Payer: Hamaspik Choice Inc Medicare	$392.50

REAMER CONCAVE 018

Facility

$2,315.00

Hospital Charge Code	64906128
Hospital Revenue Code	270
Min. Negotiated Rate	$810.25
Max. Negotiated Rate	$1,852.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,273.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,157.50
Rate for Payer: Aetna Government	$1,157.50
Rate for Payer: Brighton Health Commercial	$1,736.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,852.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,574.20
Rate for Payer: Group Health Inc Commercial	$1,157.50
Rate for Payer: Group Health Inc Medicare	$810.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,157.50

REAMER CONCAVE 020

Facility

$2,315.00

Hospital Charge Code	64906129
Hospital Revenue Code	270
Min. Negotiated Rate	$810.25
Max. Negotiated Rate	$1,852.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,273.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,157.50
Rate for Payer: Aetna Government	$1,157.50
Rate for Payer: Brighton Health Commercial	$1,736.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,852.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,574.20
Rate for Payer: Group Health Inc Commercial	$1,157.50
Rate for Payer: Group Health Inc Medicare	$810.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,157.50

REAMER CONVEX 016

Facility

$2,315.00

Hospital Charge Code	64906127
Hospital Revenue Code	270
Min. Negotiated Rate	$810.25
Max. Negotiated Rate	$1,852.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,273.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,157.50
Rate for Payer: Aetna Government	$1,157.50
Rate for Payer: Brighton Health Commercial	$1,736.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,852.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,574.20
Rate for Payer: Group Health Inc Commercial	$1,157.50
Rate for Payer: Group Health Inc Medicare	$810.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,157.50

REAMER HAND COUGHLIN 10MM

Facility

$1,447.50

Service Code	HCPCS C1713
Hospital Charge Code	64904910
Hospital Revenue Code	278
Min. Negotiated Rate	$723.75
Max. Negotiated Rate	$723.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$723.75
Rate for Payer: Hamaspik Choice Inc Medicare	$723.75

REAMER HAND COUGHLIN 10MM

Facility

$1,447.50

Service Code	HCPCS C1713
Hospital Charge Code	64904910
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,519.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$796.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$868.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$723.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$832.31
Rate for Payer: EmblemHealth Commercial	$723.75
Rate for Payer: Fidelis Medicare Advantage	$1,519.88
Rate for Payer: Group Health Inc Commercial	$723.75
Rate for Payer: Group Health Inc Medicare	$506.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$723.75
Rate for Payer: Hamaspik Choice Inc Medicare	$723.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$940.88

REAMER HAND COUGHLIN 12MM

Facility

$1,447.50

Service Code	HCPCS C1713
Hospital Charge Code	64904912
Hospital Revenue Code	278
Min. Negotiated Rate	$723.75
Max. Negotiated Rate	$723.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$723.75
Rate for Payer: Hamaspik Choice Inc Medicare	$723.75

REAMER HAND COUGHLIN 12MM

Facility

$1,447.50

Service Code	HCPCS C1713
Hospital Charge Code	64904912
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,519.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$796.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$868.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$723.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$832.31
Rate for Payer: EmblemHealth Commercial	$723.75
Rate for Payer: Fidelis Medicare Advantage	$1,519.88
Rate for Payer: Group Health Inc Commercial	$723.75
Rate for Payer: Group Health Inc Medicare	$506.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$723.75
Rate for Payer: Hamaspik Choice Inc Medicare	$723.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$940.88

REAMER HAND SURFACING 22MM B

Facility

$2,315.00

Hospital Charge Code	64906014
Hospital Revenue Code	270
Min. Negotiated Rate	$810.25
Max. Negotiated Rate	$1,852.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,273.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,157.50
Rate for Payer: Aetna Government	$1,157.50
Rate for Payer: Brighton Health Commercial	$1,736.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,852.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,574.20
Rate for Payer: Group Health Inc Commercial	$1,157.50
Rate for Payer: Group Health Inc Medicare	$810.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,157.50

REAMER LO PROFILE

Facility

$487.50

Hospital Charge Code	64905800
Hospital Revenue Code	270
Min. Negotiated Rate	$170.62
Max. Negotiated Rate	$390.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$243.75
Rate for Payer: Aetna Government	$243.75
Rate for Payer: Brighton Health Commercial	$365.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$390.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$331.50
Rate for Payer: Group Health Inc Commercial	$243.75
Rate for Payer: Group Health Inc Medicare	$170.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75

REAMER LOW PROFILE

Facility

$487.50

Hospital Charge Code	64905352
Hospital Revenue Code	270
Min. Negotiated Rate	$170.62
Max. Negotiated Rate	$390.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$243.75
Rate for Payer: Aetna Government	$243.75
Rate for Payer: Brighton Health Commercial	$365.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$390.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$331.50
Rate for Payer: Group Health Inc Commercial	$243.75
Rate for Payer: Group Health Inc Medicare	$170.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75

REAMER S10

Facility

$801.55

Hospital Charge Code	64907106
Hospital Revenue Code	270
Min. Negotiated Rate	$280.54
Max. Negotiated Rate	$641.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$440.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$400.77
Rate for Payer: Aetna Government	$400.77
Rate for Payer: Brighton Health Commercial	$601.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$641.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$545.05
Rate for Payer: Group Health Inc Commercial	$400.77
Rate for Payer: Group Health Inc Medicare	$280.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$400.77
Rate for Payer: Hamaspik Choice Inc Medicare	$400.77

REAMER SHAFT 8.0MM

Facility

$537.50

Hospital Charge Code	64904776
Hospital Revenue Code	270
Min. Negotiated Rate	$188.12
Max. Negotiated Rate	$430.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$295.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$268.75
Rate for Payer: Aetna Government	$268.75
Rate for Payer: Brighton Health Commercial	$403.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$430.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$365.50
Rate for Payer: Group Health Inc Commercial	$268.75
Rate for Payer: Group Health Inc Medicare	$188.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$268.75
Rate for Payer: Hamaspik Choice Inc Medicare	$268.75

REAMER SHAFT, 8X284MM

Facility

$430.00

Hospital Charge Code	40005865
Hospital Revenue Code	272
Min. Negotiated Rate	$150.50
Max. Negotiated Rate	$344.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$236.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$215.00
Rate for Payer: Aetna Government	$215.00
Rate for Payer: Brighton Health Commercial	$322.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$344.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$292.40
Rate for Payer: Group Health Inc Commercial	$215.00
Rate for Payer: Group Health Inc Medicare	$150.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$215.00
Rate for Payer: Hamaspik Choice Inc Medicare	$215.00

REAMER SHAFT AOFT MDLR 450MM

Facility

$391.30

Hospital Charge Code	64906769
Hospital Revenue Code	279
Min. Negotiated Rate	$136.96
Max. Negotiated Rate	$313.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$215.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$195.65
Rate for Payer: Aetna Government	$195.65
Rate for Payer: Brighton Health Commercial	$293.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$313.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$266.08
Rate for Payer: Group Health Inc Commercial	$195.65
Rate for Payer: Group Health Inc Medicare	$136.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.65
Rate for Payer: Hamaspik Choice Inc Medicare	$195.65

RE-ATTACHMENT FINGER

Facility

$10,851.90

Service Code	HCPCS 20816
Hospital Charge Code	40021610
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$8,138.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,968.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,142.79
Rate for Payer: Aetna Government	$2,142.79
Rate for Payer: Brighton Health Commercial	$8,138.93
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: Group Health Inc Commercial	$5,425.95
Rate for Payer: Group Health Inc Medicare	$3,798.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,425.95
Rate for Payer: Hamaspik Choice Inc Medicare	$5,425.95
Rate for Payer: United Healthcare Commercial	$2,546.00

REBASE COMPLETE LOWER DENTURE

Facility

$425.00

Service Code	HCPCS D5711
Hospital Charge Code	42301105
Hospital Revenue Code	361
Min. Negotiated Rate	$148.75
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$233.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.91
Rate for Payer: Aetna Government	$155.91
Rate for Payer: Brighton Health Commercial	$318.75
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: Group Health Inc Commercial	$212.50
Rate for Payer: Group Health Inc Medicare	$148.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$212.50
Rate for Payer: Hamaspik Choice Inc Medicare	$212.50

REBASE COMPLETE UPPER DENTURE

Facility

$425.00

Service Code	HCPCS D5710
Hospital Charge Code	42301100
Hospital Revenue Code	361
Min. Negotiated Rate	$148.75
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$233.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$163.15
Rate for Payer: Aetna Government	$163.15
Rate for Payer: Brighton Health Commercial	$318.75
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: Group Health Inc Commercial	$212.50
Rate for Payer: Group Health Inc Medicare	$148.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$212.50
Rate for Payer: Hamaspik Choice Inc Medicare	$212.50

REBASE LOWER PARTIAL DENTURE

Facility

$435.00

Service Code	HCPCS D5721
Hospital Charge Code	42301115
Hospital Revenue Code	361
Min. Negotiated Rate	$152.25
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$239.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$154.49
Rate for Payer: Aetna Government	$154.49
Rate for Payer: Brighton Health Commercial	$326.25
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: Group Health Inc Commercial	$217.50
Rate for Payer: Group Health Inc Medicare	$152.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$217.50
Rate for Payer: Hamaspik Choice Inc Medicare	$217.50

REBASE UPPER PARTIAL DENTURE

Facility

$435.00

Service Code	HCPCS D5720
Hospital Charge Code	42301110
Hospital Revenue Code	361
Min. Negotiated Rate	$152.25
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$239.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$154.49
Rate for Payer: Aetna Government	$154.49
Rate for Payer: Brighton Health Commercial	$326.25
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: Group Health Inc Commercial	$217.50
Rate for Payer: Group Health Inc Medicare	$152.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$217.50
Rate for Payer: Hamaspik Choice Inc Medicare	$217.50

RECEMENT BRIDGE

Facility

$112.50

Service Code	HCPCS D6930
Hospital Charge Code	42301585
Hospital Revenue Code	361
Min. Negotiated Rate	$38.55
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$38.55
Rate for Payer: Aetna Government	$38.55
Rate for Payer: Brighton Health Commercial	$84.38
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: Group Health Inc Commercial	$56.25
Rate for Payer: Group Health Inc Medicare	$39.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.25
Rate for Payer: Hamaspik Choice Inc Medicare	$56.25

Know your out-of-pocket cost for care.

All Charges