St. Barnabas Hospital

All Charges

Charge

Type

Price

TROCAR VERSPRT BLDS

Facility OP

$65.10

Hospital Charge Code	64907103
Hospital Revenue Code	270
Min. Negotiated Rate	$22.78
Max. Negotiated Rate	$52.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.55
Rate for Payer: Aetna Government	$32.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.27
Rate for Payer: Group Health Inc Commercial	$32.55
Rate for Payer: Group Health Inc Medicare	$22.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.55
Rate for Payer: Hamaspik Choice Inc Medicare	$32.55

TROCAR,XCEL,BLESS,ST SLV,5/150MM

Facility OP

$100.09

Hospital Charge Code	64904624
Hospital Revenue Code	270
Min. Negotiated Rate	$35.03
Max. Negotiated Rate	$80.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.04
Rate for Payer: Aetna Government	$50.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.06
Rate for Payer: Group Health Inc Commercial	$50.04
Rate for Payer: Group Health Inc Medicare	$35.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.04
Rate for Payer: Hamaspik Choice Inc Medicare	$50.04

TROCAR, XCEL, BL, STA SLV 5/100MM

Facility OP

$86.28

Hospital Charge Code	64904361
Hospital Revenue Code	270
Min. Negotiated Rate	$30.20
Max. Negotiated Rate	$69.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.14
Rate for Payer: Aetna Government	$43.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$69.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.67
Rate for Payer: Group Health Inc Commercial	$43.14
Rate for Payer: Group Health Inc Medicare	$30.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.14
Rate for Payer: Hamaspik Choice Inc Medicare	$43.14

TROCAR,XCEL,BLUNT TIP,12MMX100MM

Facility OP

$147.01

Hospital Charge Code	64904373
Hospital Revenue Code	270
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$117.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.50
Rate for Payer: Aetna Government	$73.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$117.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.97
Rate for Payer: Group Health Inc Commercial	$73.50
Rate for Payer: Group Health Inc Medicare	$51.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.50
Rate for Payer: Hamaspik Choice Inc Medicare	$73.50

TROCAR XCEL BLUNT TIP 12X100MM

Facility OP

$73.03

Hospital Charge Code	64906045
Hospital Revenue Code	270
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$58.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$40.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$36.52
Rate for Payer: Aetna Government	$36.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.66
Rate for Payer: Group Health Inc Commercial	$36.52
Rate for Payer: Group Health Inc Medicare	$25.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.52
Rate for Payer: Hamaspik Choice Inc Medicare	$36.52

TROCAR,XCEL W OPTIVIEW,BLADELESS

Facility OP

$112.50

Hospital Charge Code	64905225
Hospital Revenue Code	270
Min. Negotiated Rate	$39.38
Max. Negotiated Rate	$90.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.25
Rate for Payer: Aetna Government	$56.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.50
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

TROCATH TRAY

Facility OP

$57.06

Hospital Charge Code	40505905
Hospital Revenue Code	260
Min. Negotiated Rate	$19.97
Max. Negotiated Rate	$45.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.53
Rate for Payer: Aetna Government	$28.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.80
Rate for Payer: Group Health Inc Commercial	$28.53
Rate for Payer: Group Health Inc Medicare	$19.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.53
Rate for Payer: Hamaspik Choice Inc Medicare	$28.53

TROCHANTERIC PLATE

Facility IP

$4,368.00

Service Code	HCPCS C1713
Hospital Charge Code	40209865
Hospital Revenue Code	278
Min. Negotiated Rate	$2,184.00
Max. Negotiated Rate	$2,184.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,184.00

TROCHANTERIC PLATE

Facility OP

$4,368.00

Service Code	HCPCS C1713
Hospital Charge Code	40209865
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,586.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,402.40
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	$2,184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,511.60
Rate for Payer: Fidelis Medicare Advantage	$4,586.40
Rate for Payer: Group Health Inc Commercial	$2,184.00
Rate for Payer: Group Health Inc Medicare	$1,528.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,184.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,839.20

TROCH PLT PROV, NARROW, LEFT

Facility OP

$823.18

Service Code	HCPCS C1713
Hospital Charge Code	40006817
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$864.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$452.75
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	$411.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$473.33
Rate for Payer: Fidelis Medicare Advantage	$864.34
Rate for Payer: Group Health Inc Commercial	$411.59
Rate for Payer: Group Health Inc Medicare	$288.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.59
Rate for Payer: Hamaspik Choice Inc Medicare	$411.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$535.07

TROCH PLT PROV, NARROW, LEFT

Facility IP

$823.18

Service Code	HCPCS C1713
Hospital Charge Code	40006817
Hospital Revenue Code	278
Min. Negotiated Rate	$411.59
Max. Negotiated Rate	$411.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.59
Rate for Payer: Hamaspik Choice Inc Medicare	$411.59

TROCH PLT PROV, WIDE, LEFT

Facility IP

$823.18

Service Code	HCPCS C1713
Hospital Charge Code	40006819
Hospital Revenue Code	278
Min. Negotiated Rate	$411.59
Max. Negotiated Rate	$411.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.59
Rate for Payer: Hamaspik Choice Inc Medicare	$411.59

TROCH PLT PROV, WIDE, LEFT

Facility OP

$823.18

Service Code	HCPCS C1713
Hospital Charge Code	40006819
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$864.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$452.75
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	$411.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$473.33
Rate for Payer: Fidelis Medicare Advantage	$864.34
Rate for Payer: Group Health Inc Commercial	$411.59
Rate for Payer: Group Health Inc Medicare	$288.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.59
Rate for Payer: Hamaspik Choice Inc Medicare	$411.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$535.07

TROCH PLT PROV, WIDE, RIGHT

Facility IP

$823.18

Service Code	HCPCS C1713
Hospital Charge Code	40006818
Hospital Revenue Code	278
Min. Negotiated Rate	$411.59
Max. Negotiated Rate	$411.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.59
Rate for Payer: Hamaspik Choice Inc Medicare	$411.59

TROCH PLT PROV, WIDE, RIGHT

Facility OP

$823.18

Service Code	HCPCS C1713
Hospital Charge Code	40006818
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$864.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$452.75
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	$411.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$473.33
Rate for Payer: Fidelis Medicare Advantage	$864.34
Rate for Payer: Group Health Inc Commercial	$411.59
Rate for Payer: Group Health Inc Medicare	$288.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.59
Rate for Payer: Hamaspik Choice Inc Medicare	$411.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$535.07

TROC PLT PROV, NARROW, RIGHT

Facility IP

$823.18

Service Code	HCPCS C1713
Hospital Charge Code	40006816
Hospital Revenue Code	278
Min. Negotiated Rate	$411.59
Max. Negotiated Rate	$411.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.59
Rate for Payer: Hamaspik Choice Inc Medicare	$411.59

TROC PLT PROV, NARROW, RIGHT

Facility OP

$823.18

Service Code	HCPCS C1713
Hospital Charge Code	40006816
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$864.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$452.75
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	$411.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$473.33
Rate for Payer: Fidelis Medicare Advantage	$864.34
Rate for Payer: Group Health Inc Commercial	$411.59
Rate for Payer: Group Health Inc Medicare	$288.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.59
Rate for Payer: Hamaspik Choice Inc Medicare	$411.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$535.07

TROFILE(R)

Facility OP

$4,900.00

Service Code	HCPCS 87999
Hospital Charge Code	40609155
Hospital Revenue Code	300
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$2,695.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,695.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,450.00
Rate for Payer: Aetna Government	$2,450.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.31
Rate for Payer: Group Health Inc Commercial	$2,450.00
Rate for Payer: Group Health Inc Medicare	$1,715.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,450.00

TROMETHAMINE 36MG/ML 500ML

Facility OP

$303.40

Hospital Charge Code	41658443
Hospital Revenue Code	250
Min. Negotiated Rate	$106.19
Max. Negotiated Rate	$242.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$166.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$151.70
Rate for Payer: Aetna Government	$151.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$242.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$206.31
Rate for Payer: Group Health Inc Commercial	$151.70
Rate for Payer: Group Health Inc Medicare	$106.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$151.70
Rate for Payer: Hamaspik Choice Inc Medicare	$151.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$197.21

TROMETHAMINE 36MG/ML 500ML

Facility OP

$303.40

Hospital Charge Code	41648443
Hospital Revenue Code	250
Min. Negotiated Rate	$106.19
Max. Negotiated Rate	$242.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$166.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$151.70
Rate for Payer: Aetna Government	$151.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$242.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$206.31
Rate for Payer: Group Health Inc Commercial	$151.70
Rate for Payer: Group Health Inc Medicare	$106.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$151.70
Rate for Payer: Hamaspik Choice Inc Medicare	$151.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$197.21

TRONOGESTREL 68MG

Facility IP

$39.30

Service Code	HCPCS J7307
Hospital Charge Code	41646614
Hospital Revenue Code	636
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.65
Rate for Payer: Hamaspik Choice Inc Medicare	$19.65

TRONOGESTREL 68MG

Facility OP

$39.30

Service Code	HCPCS J7307
Hospital Charge Code	41646614
Hospital Revenue Code	636
Min. Negotiated Rate	$13.76
Max. Negotiated Rate	$1,030.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,030.64
Rate for Payer: Aetna Government	$1,030.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.60
Rate for Payer: Group Health Inc Commercial	$19.65
Rate for Payer: Group Health Inc Medicare	$13.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.65
Rate for Payer: Hamaspik Choice Inc Medicare	$19.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$25.54

TROPICAMIDE 0.5% OPHTHALMIC SOLN 15 ML

Facility OP

$9.60

Hospital Charge Code	41641152
Hospital Revenue Code	250
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$7.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.80
Rate for Payer: Aetna Government	$4.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.53
Rate for Payer: Group Health Inc Commercial	$4.80
Rate for Payer: Group Health Inc Medicare	$3.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.80
Rate for Payer: Hamaspik Choice Inc Medicare	$4.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.24

TROPICAMIDE 0.5% OPHTHALMIC SOLN 15 ML

Facility OP

$9.60

Hospital Charge Code	41651152
Hospital Revenue Code	250
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$7.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.80
Rate for Payer: Aetna Government	$4.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.53
Rate for Payer: Group Health Inc Commercial	$4.80
Rate for Payer: Group Health Inc Medicare	$3.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.80
Rate for Payer: Hamaspik Choice Inc Medicare	$4.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.24

TROPICAMIDE 1% OPHTHALMIC SOLN 15 ML

Facility OP

$10.74

Hospital Charge Code	41651943
Hospital Revenue Code	250
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$8.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.37
Rate for Payer: Aetna Government	$5.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.30
Rate for Payer: Group Health Inc Commercial	$5.37
Rate for Payer: Group Health Inc Medicare	$3.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.37
Rate for Payer: Hamaspik Choice Inc Medicare	$5.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.98

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