St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BACTERIAL ANTIGENS COMPLET, URINE

Facility

$28.85

Service Code	HCPCS 86403
Hospital Charge Code	40728011
Hospital Revenue Code	302
Rate for Payer: Cash Price	$11.54

BACTERIAL ANTIGENS COMPLET, URINE

Facility

$28.85

Service Code	HCPCS 86403
Hospital Charge Code	40728011
Hospital Revenue Code	302
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$21.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.54
Rate for Payer: Aetna Government	$11.54
Rate for Payer: Affinity Essential Plan 1&2	$8.08
Rate for Payer: Affinity Essential Plan 3&4	$8.08
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.08
Rate for Payer: Brighton Health Commercial	$21.64
Rate for Payer: Cash Price	$11.54
Rate for Payer: Cash Price	$11.54
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$11.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.70
Rate for Payer: Elderplan Medicare Advantage	$11.54
Rate for Payer: EmblemHealth Commercial	$11.54
Rate for Payer: Fidelis Essential Plan Aliesa	$9.81
Rate for Payer: Fidelis Essential Plan QHP	$10.27
Rate for Payer: Fidelis Medicare Advantage	$11.54
Rate for Payer: Fidelis Qualified Health Plan	$10.27
Rate for Payer: Group Health Inc Commercial	$11.54
Rate for Payer: Group Health Inc Medicare	$11.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.42
Rate for Payer: Hamaspik Choice Inc Medicare	$11.54
Rate for Payer: Healthfirst Medicare Advantage	$11.54
Rate for Payer: Healthfirst QHP	$11.54
Rate for Payer: Humana Medicare	$11.77
Rate for Payer: Senior Whole Health Medicare Advantage	$11.54
Rate for Payer: United Healthcare Commercial	$12.91
Rate for Payer: United Healthcare Medicare Advantage	$11.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.54
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9.23
Rate for Payer: Wellcare Medicare	$10.39

BACTERIAL REPLACEMENT FILTER

Facility

$1,012.40

Hospital Charge Code	64902960
Hospital Revenue Code	270
Min. Negotiated Rate	$354.34
Max. Negotiated Rate	$809.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$556.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$506.20
Rate for Payer: Aetna Government	$506.20
Rate for Payer: Brighton Health Commercial	$759.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$809.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$688.43
Rate for Payer: Group Health Inc Commercial	$506.20
Rate for Payer: Group Health Inc Medicare	$354.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$506.20
Rate for Payer: Hamaspik Choice Inc Medicare	$506.20

BACTERIOLOGIC STUDIES FOR DETERM.

Facility

$141.75

Service Code	HCPCS D0415
Hospital Charge Code	42300195
Hospital Revenue Code	361
Min. Negotiated Rate	$10.68
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.68
Rate for Payer: Aetna Government	$10.68
Rate for Payer: Brighton Health Commercial	$106.31
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	$70.88
Rate for Payer: Group Health Inc Medicare	$49.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.88
Rate for Payer: Hamaspik Choice Inc Medicare	$70.88

BACTERIOSTATIC WATER(BENZ ALC) IJ SOLN [14979]

Facility

$0.07

Service Code	NDC 00409397703
Hospital Charge Code	00409397703
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

BACTOSHIELD CHG 4% STERIS

Facility

$47.39

Hospital Charge Code	64902774
Hospital Revenue Code	270
Min. Negotiated Rate	$16.59
Max. Negotiated Rate	$37.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.70
Rate for Payer: Aetna Government	$23.70
Rate for Payer: Brighton Health Commercial	$35.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.23
Rate for Payer: Group Health Inc Commercial	$23.70
Rate for Payer: Group Health Inc Medicare	$16.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.70
Rate for Payer: Hamaspik Choice Inc Medicare	$23.70

BADGES RADIATION MONITORING,MDC

Facility

$122.70

Hospital Charge Code	64903686
Hospital Revenue Code	270
Min. Negotiated Rate	$42.94
Max. Negotiated Rate	$98.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$61.35
Rate for Payer: Aetna Government	$61.35
Rate for Payer: Brighton Health Commercial	$92.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$98.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$83.44
Rate for Payer: Group Health Inc Commercial	$61.35
Rate for Payer: Group Health Inc Medicare	$42.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.35
Rate for Payer: Hamaspik Choice Inc Medicare	$61.35

BAG,BILE,W/STRAPS

Facility

$20.13

Hospital Charge Code	64901495
Hospital Revenue Code	270
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$16.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.06
Rate for Payer: Aetna Government	$10.06
Rate for Payer: Brighton Health Commercial	$15.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.69
Rate for Payer: Group Health Inc Commercial	$10.06
Rate for Payer: Group Health Inc Medicare	$7.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.06
Rate for Payer: Hamaspik Choice Inc Medicare	$10.06

BAG BREATHING 2-LITER

Facility

$6.25

Hospital Charge Code	64904830
Hospital Revenue Code	270
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$5.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.12
Rate for Payer: Aetna Government	$3.12
Rate for Payer: Brighton Health Commercial	$4.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.25
Rate for Payer: Group Health Inc Commercial	$3.12
Rate for Payer: Group Health Inc Medicare	$2.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3.12

BAG COLLECTION EDS 3 CSF CODMAN

Facility

$103.00

Hospital Charge Code	64901317
Hospital Revenue Code	270
Min. Negotiated Rate	$36.05
Max. Negotiated Rate	$82.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.50
Rate for Payer: Aetna Government	$51.50
Rate for Payer: Brighton Health Commercial	$77.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$82.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$70.04
Rate for Payer: Group Health Inc Commercial	$51.50
Rate for Payer: Group Health Inc Medicare	$36.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.50
Rate for Payer: Hamaspik Choice Inc Medicare	$51.50

BAG COLLECTION FECAL MGT SYST

Facility

$8.75

Hospital Charge Code	64901125
Hospital Revenue Code	270
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$7.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.38
Rate for Payer: Aetna Government	$4.38
Rate for Payer: Brighton Health Commercial	$6.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.95
Rate for Payer: Group Health Inc Commercial	$4.38
Rate for Payer: Group Health Inc Medicare	$3.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.38
Rate for Payer: Hamaspik Choice Inc Medicare	$4.38

BAG,COLLECT,PRIVACY,FLEXISEAL

Facility

$8.75

Hospital Charge Code	64901580
Hospital Revenue Code	270
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$7.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.38
Rate for Payer: Aetna Government	$4.38
Rate for Payer: Brighton Health Commercial	$6.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.95
Rate for Payer: Group Health Inc Commercial	$4.38
Rate for Payer: Group Health Inc Medicare	$3.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.38
Rate for Payer: Hamaspik Choice Inc Medicare	$4.38

BAG DRAINAGE 2000ML W/ANTI REFLUX

Facility

$8.03

Hospital Charge Code	64901859
Hospital Revenue Code	270
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$6.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.02
Rate for Payer: Aetna Government	$4.02
Rate for Payer: Brighton Health Commercial	$6.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.46
Rate for Payer: Group Health Inc Commercial	$4.02
Rate for Payer: Group Health Inc Medicare	$2.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.02
Rate for Payer: Hamaspik Choice Inc Medicare	$4.02

BAG DRAIN W MICRO TUBE

Facility

$8.85

Hospital Charge Code	64901977
Hospital Revenue Code	270
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$7.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.42
Rate for Payer: Aetna Government	$4.42
Rate for Payer: Brighton Health Commercial	$6.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.02
Rate for Payer: Group Health Inc Commercial	$4.42
Rate for Payer: Group Health Inc Medicare	$3.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.42
Rate for Payer: Hamaspik Choice Inc Medicare	$4.42

BAG ENEMA

Facility

$4.41

Hospital Charge Code	64901155
Hospital Revenue Code	270
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$3.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.20
Rate for Payer: Aetna Government	$2.20
Rate for Payer: Brighton Health Commercial	$3.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.00
Rate for Payer: Group Health Inc Commercial	$2.20
Rate for Payer: Group Health Inc Medicare	$1.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.20
Rate for Payer: Hamaspik Choice Inc Medicare	$2.20

BAG,LEG,DISPOSABAG,LTX-STRAP,MED

Facility

$3.93

Hospital Charge Code	64902221
Hospital Revenue Code	270
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$3.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.96
Rate for Payer: Aetna Government	$1.96
Rate for Payer: Brighton Health Commercial	$2.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.67
Rate for Payer: Group Health Inc Commercial	$1.96
Rate for Payer: Group Health Inc Medicare	$1.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.96
Rate for Payer: Hamaspik Choice Inc Medicare	$1.96

BAG,PRESSURE INFUSOR, 1000ML

Facility

$24.61

Hospital Charge Code	64902091
Hospital Revenue Code	270
Min. Negotiated Rate	$8.61
Max. Negotiated Rate	$19.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.30
Rate for Payer: Aetna Government	$12.30
Rate for Payer: Brighton Health Commercial	$18.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.73
Rate for Payer: Group Health Inc Commercial	$12.30
Rate for Payer: Group Health Inc Medicare	$8.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.30
Rate for Payer: Hamaspik Choice Inc Medicare	$12.30

BAG,PRESSURE INFUSOR,500ML

Facility

$181.77

Hospital Charge Code	64901846
Hospital Revenue Code	270
Min. Negotiated Rate	$63.62
Max. Negotiated Rate	$145.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$99.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$90.88
Rate for Payer: Aetna Government	$90.88
Rate for Payer: Brighton Health Commercial	$136.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$145.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$123.60
Rate for Payer: Group Health Inc Commercial	$90.88
Rate for Payer: Group Health Inc Medicare	$63.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.88
Rate for Payer: Hamaspik Choice Inc Medicare	$90.88

BAG RESUCITATION EQUIPMENT

Facility

$0.65

Hospital Charge Code	64902248
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.33
Rate for Payer: Aetna Government	$0.33
Rate for Payer: Brighton Health Commercial	$0.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.44
Rate for Payer: Group Health Inc Commercial	$0.33
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33
Rate for Payer: Hamaspik Choice Inc Medicare	$0.33

BAG SET UP

Facility

$0.24

Hospital Charge Code	64902245
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Brighton Health Commercial	$0.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: Group Health Inc Commercial	$0.12
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12
Rate for Payer: Hamaspik Choice Inc Medicare	$0.12

BAG SPECIMEN 6X9 ZIP LOCK (102)

Facility

$123.13

Hospital Charge Code	64901876
Hospital Revenue Code	270
Min. Negotiated Rate	$43.10
Max. Negotiated Rate	$98.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$61.56
Rate for Payer: Aetna Government	$61.56
Rate for Payer: Brighton Health Commercial	$92.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$98.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$83.73
Rate for Payer: Group Health Inc Commercial	$61.56
Rate for Payer: Group Health Inc Medicare	$43.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.56
Rate for Payer: Hamaspik Choice Inc Medicare	$61.56

BAG,SPECIMEN,BIOHAZ,ZIP,6X9

Facility

$0.11

Hospital Charge Code	64901853
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06

BAG,SPECIMEN RETRIEVAL,224 ML

Facility

$990.00

Hospital Charge Code	64904559
Hospital Revenue Code	270
Min. Negotiated Rate	$346.50
Max. Negotiated Rate	$792.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$544.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$495.00
Rate for Payer: Aetna Government	$495.00
Rate for Payer: Brighton Health Commercial	$742.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$792.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$673.20
Rate for Payer: Group Health Inc Commercial	$495.00
Rate for Payer: Group Health Inc Medicare	$346.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$495.00
Rate for Payer: Hamaspik Choice Inc Medicare	$495.00

BAG SPONGE COUNTER

Facility

$0.78

Hospital Charge Code	40201028
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.39
Rate for Payer: Aetna Government	$0.39
Rate for Payer: Brighton Health Commercial	$0.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.53
Rate for Payer: Group Health Inc Commercial	$0.39
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39
Rate for Payer: Hamaspik Choice Inc Medicare	$0.39

BAG SPONGE COUNTER OPAQUE

Facility

$0.78

Hospital Charge Code	64903039
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.39
Rate for Payer: Aetna Government	$0.39
Rate for Payer: Brighton Health Commercial	$0.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.53
Rate for Payer: Group Health Inc Commercial	$0.39
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39
Rate for Payer: Hamaspik Choice Inc Medicare	$0.39

Know your out-of-pocket cost for care.

All Charges