St. Barnabas Hospital

All Charges

Charge

Type

Price

ZIDOVUDINE + LAMIVUDINE 150 MG - 300 MG

Facility OP

$28.00

Hospital Charge Code	41652197
Hospital Revenue Code	250
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$22.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.00
Rate for Payer: Aetna Government	$14.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.04
Rate for Payer: Group Health Inc Commercial	$14.00
Rate for Payer: Group Health Inc Medicare	$9.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.00
Rate for Payer: Hamaspik Choice Inc Medicare	$14.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.20

ZIKA VIRUS MAC-ELISA (EUA)

Facility OP

$32.20

Service Code	HCPCS 86790
Hospital Charge Code	40729908
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$20.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.88
Rate for Payer: Aetna Government	$12.88
Rate for Payer: Cash Price	$12.88
Rate for Payer: Cash Price	$12.88
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.32
Rate for Payer: Elderplan Medicare Advantage	$12.88
Rate for Payer: EmblemHealth Commercial	$12.88
Rate for Payer: Fidelis CHP/HARP/Medicaid	$11.59
Rate for Payer: Fidelis Essential Plan Aliesa	$10.95
Rate for Payer: Fidelis Essential Plan QHP	$11.46
Rate for Payer: Fidelis Medicare Advantage	$12.88
Rate for Payer: Fidelis Qualified Health Plan	$11.46
Rate for Payer: Group Health Inc Commercial	$12.88
Rate for Payer: Group Health Inc Medicare	$12.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.10
Rate for Payer: Hamaspik Choice Inc Medicare	$12.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$12.88
Rate for Payer: Healthfirst Medicare Advantage	$12.88
Rate for Payer: Healthfirst QHP	$12.88
Rate for Payer: Senior Whole Health Medicare Advantage	$12.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.30
Rate for Payer: Wellcare Medicare	$11.59

ZIKA VIRUS NAA COMPREHENSIVE

Facility OP

$87.73

Service Code	HCPCS 87798
Hospital Charge Code	40729907
Hospital Revenue Code	306
Min. Negotiated Rate	$28.07
Max. Negotiated Rate	$55.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.09
Rate for Payer: Aetna Government	$35.09
Rate for Payer: Cash Price	$35.09
Rate for Payer: Cash Price	$35.09
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$35.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.20
Rate for Payer: Elderplan Medicare Advantage	$35.09
Rate for Payer: EmblemHealth Commercial	$35.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31.58
Rate for Payer: Fidelis Essential Plan Aliesa	$29.83
Rate for Payer: Fidelis Essential Plan QHP	$31.23
Rate for Payer: Fidelis Medicare Advantage	$35.09
Rate for Payer: Fidelis Qualified Health Plan	$31.23
Rate for Payer: Group Health Inc Commercial	$35.09
Rate for Payer: Group Health Inc Medicare	$35.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.86
Rate for Payer: Hamaspik Choice Inc Medicare	$35.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35.09
Rate for Payer: Healthfirst Medicare Advantage	$35.09
Rate for Payer: Healthfirst QHP	$35.09
Rate for Payer: Senior Whole Health Medicare Advantage	$35.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28.07
Rate for Payer: Wellcare Medicare	$31.58

ZIM 15X13MM 6MM HEIGHT SPACER

Facility IP

$4,656.00

Service Code	HCPCS C1776
Hospital Charge Code	40005203
Hospital Revenue Code	278
Min. Negotiated Rate	$2,328.00
Max. Negotiated Rate	$2,328.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,328.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,328.00

ZIM 15X13MM 6MM HEIGHT SPACER

Facility OP

$4,656.00

Service Code	HCPCS C1776
Hospital Charge Code	40005203
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,888.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,560.80
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	$2,328.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,677.20
Rate for Payer: Fidelis Medicare Advantage	$4,888.80
Rate for Payer: Group Health Inc Commercial	$2,328.00
Rate for Payer: Group Health Inc Medicare	$1,629.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,328.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,328.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,026.40

ZIM 6MM ZERO PLATE

Facility OP

$890.00

Service Code	HCPCS C1776
Hospital Charge Code	40005204
Hospital Revenue Code	278
Min. Negotiated Rate	$311.50
Max. Negotiated Rate	$934.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$489.50
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	$445.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$511.75
Rate for Payer: Fidelis Medicare Advantage	$934.50
Rate for Payer: Group Health Inc Commercial	$445.00
Rate for Payer: Group Health Inc Medicare	$311.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$578.50

ZIM 6MM ZERO PLATE

Facility IP

$890.00

Service Code	HCPCS C1776
Hospital Charge Code	40005204
Hospital Revenue Code	278
Min. Negotiated Rate	$445.00
Max. Negotiated Rate	$445.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00

ZIM ACET NEUT LINER 36 MM SZ KK

Facility IP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40204256
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00

ZIM ACET NEUT LINER 36 MM SZ KK

Facility OP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40204256
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,570.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
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	$1,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,955.00
Rate for Payer: Fidelis Medicare Advantage	$3,570.00
Rate for Payer: Group Health Inc Commercial	$1,700.00
Rate for Payer: Group Health Inc Medicare	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,210.00

ZIM ACET NEUT LINER 36MM SZ KK

Facility OP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40204250
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,570.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
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	$1,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,955.00
Rate for Payer: Fidelis Medicare Advantage	$3,570.00
Rate for Payer: Group Health Inc Commercial	$1,700.00
Rate for Payer: Group Health Inc Medicare	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,210.00

ZIM ACET NEUT LINER 36MM SZ KK

Facility IP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40204250
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00

ZIM ACET NEUT LINER 46MM SZ LL

Facility OP

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40009278
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,990.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,090.00
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	$1,900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,185.00
Rate for Payer: Fidelis Medicare Advantage	$3,990.00
Rate for Payer: Group Health Inc Commercial	$1,900.00
Rate for Payer: Group Health Inc Medicare	$1,330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,470.00

ZIM ACET NEUT LINER 46MM SZ LL

Facility IP

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40009278
Hospital Revenue Code	278
Min. Negotiated Rate	$1,900.00
Max. Negotiated Rate	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00

ZIM AC LINER 36MM SIZE II

Facility IP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40008322
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00

ZIM AC LINER 36MM SIZE II

Facility OP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40008322
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,570.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
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	$1,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,955.00
Rate for Payer: Fidelis Medicare Advantage	$3,570.00
Rate for Payer: Group Health Inc Commercial	$1,700.00
Rate for Payer: Group Health Inc Medicare	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,210.00

ZIM AVEN MUL STEM STD UNCEM 6 TAP

Facility IP

$466.00

Service Code	HCPCS C1776
Hospital Charge Code	40005240
Hospital Revenue Code	278
Min. Negotiated Rate	$233.00
Max. Negotiated Rate	$233.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.00
Rate for Payer: Hamaspik Choice Inc Medicare	$233.00

ZIM AVEN MUL STEM STD UNCEM 6 TAP

Facility OP

$466.00

Service Code	HCPCS C1776
Hospital Charge Code	40005240
Hospital Revenue Code	278
Min. Negotiated Rate	$163.10
Max. Negotiated Rate	$489.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$256.30
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	$233.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$267.95
Rate for Payer: Fidelis Medicare Advantage	$489.30
Rate for Payer: Group Health Inc Commercial	$233.00
Rate for Payer: Group Health Inc Medicare	$163.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.00
Rate for Payer: Hamaspik Choice Inc Medicare	$233.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$302.90

ZIMB FEM HEAD 36/+3.5 TAPER 12/14

Facility IP

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40204434
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

ZIMB FEM HEAD 36/+3.5 TAPER 12/14

Facility OP

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40204434
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
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	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

ZIM BIOLOX FEM HEAD 36/+3.5 TAP

Facility OP

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40009274
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
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	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

ZIM BIOLOX FEM HEAD 36/+3.5 TAP

Facility IP

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40009274
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

ZIM BIO OX PTL KNEE TWIG PEG FEMO

Facility OP

$3,324.00

Service Code	HCPCS C1776
Hospital Charge Code	40202638
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,490.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,828.20
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	$1,662.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,911.30
Rate for Payer: Fidelis Medicare Advantage	$3,490.20
Rate for Payer: Group Health Inc Commercial	$1,662.00
Rate for Payer: Group Health Inc Medicare	$1,163.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,662.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,662.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,160.60

ZIM BIO OX PTL KNEE TWIG PEG FEMO

Facility IP

$3,324.00

Service Code	HCPCS C1776
Hospital Charge Code	40202638
Hospital Revenue Code	278
Min. Negotiated Rate	$1,662.00
Max. Negotiated Rate	$1,662.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,662.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,662.00

ZIM BIO PTL KNE ANATC MENSL MEDL

Facility IP

$1,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40202636
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00

ZIM BIO PTL KNE ANATC MENSL MEDL

Facility OP

$1,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40202636
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,260.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$660.00
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	$600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$690.00
Rate for Payer: Fidelis Medicare Advantage	$1,260.00
Rate for Payer: Group Health Inc Commercial	$600.00
Rate for Payer: Group Health Inc Medicare	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$780.00

Price Transparency.

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