St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BAG URINE SPECIMEN PEDS

Facility

$3.12

Hospital Charge Code	64901729
Hospital Revenue Code	270
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$2.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.56
Rate for Payer: Aetna Government	$1.56
Rate for Payer: Brighton Health Commercial	$2.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.12
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56

BAG URINE SPECIMEN PREMIE

Facility

$4.14

Hospital Charge Code	64901727
Hospital Revenue Code	270
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$3.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.07
Rate for Payer: Aetna Government	$2.07
Rate for Payer: Brighton Health Commercial	$3.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.82
Rate for Payer: Group Health Inc Commercial	$2.07
Rate for Payer: Group Health Inc Medicare	$1.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.07
Rate for Payer: Hamaspik Choice Inc Medicare	$2.07

BAIRD LEG BAG

Facility

$36.86

Hospital Charge Code	40200604
Hospital Revenue Code	270
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$29.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.43
Rate for Payer: Aetna Government	$18.43
Rate for Payer: Brighton Health Commercial	$27.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.06
Rate for Payer: Group Health Inc Commercial	$18.43
Rate for Payer: Group Health Inc Medicare	$12.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.43
Rate for Payer: Hamaspik Choice Inc Medicare	$18.43

BAIR HUGGER

Facility

$48.91

Hospital Charge Code	40209966
Hospital Revenue Code	270
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$39.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.46
Rate for Payer: Aetna Government	$24.46
Rate for Payer: Brighton Health Commercial	$36.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.26
Rate for Payer: Group Health Inc Commercial	$24.46
Rate for Payer: Group Health Inc Medicare	$17.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46

BALANCED SALT SOLUTION OPHTHALMIC 120 ML

Facility

$3.00

Hospital Charge Code	41643804
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

BALANCED SALT SOLUTION OPHTHALMIC 120 ML

Facility

$3.00

Hospital Charge Code	41653804
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

BALANCED SALT SOLUTION OPHTHALMIC 15 ML

Facility

$5.00

Hospital Charge Code	41650892
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Brighton Health Commercial	$3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

BALANCED SALT SOLUTION OPHTHALMIC 15 ML

Facility

$5.00

Hospital Charge Code	41640892
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Brighton Health Commercial	$3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

BALANCED SALT SOLUTION OPHTHALMIC 30 ML

Facility

$8.00

Hospital Charge Code	41655526
Hospital Revenue Code	250
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$6.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.00
Rate for Payer: Aetna Government	$4.00
Rate for Payer: Brighton Health Commercial	$6.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.44
Rate for Payer: Group Health Inc Commercial	$4.00
Rate for Payer: Group Health Inc Medicare	$2.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.20

BALANCED SALT SOLUTION OPHTHALMIC 30 ML

Facility

$8.00

Hospital Charge Code	41645526
Hospital Revenue Code	250
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$6.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.00
Rate for Payer: Aetna Government	$4.00
Rate for Payer: Brighton Health Commercial	$6.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.44
Rate for Payer: Group Health Inc Commercial	$4.00
Rate for Payer: Group Health Inc Medicare	$2.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.20

BALANCED SALT SOLUTION OPHTHALMIC 500 ML

Facility

$10.40

Hospital Charge Code	41652067
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$8.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.20
Rate for Payer: Aetna Government	$5.20
Rate for Payer: Brighton Health Commercial	$7.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.07
Rate for Payer: Group Health Inc Commercial	$5.20
Rate for Payer: Group Health Inc Medicare	$3.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.20
Rate for Payer: Hamaspik Choice Inc Medicare	$5.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.76

BALANCED SALT SOLUTION OPHTHALMIC 500 ML

Facility

$10.40

Hospital Charge Code	41642067
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$8.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.20
Rate for Payer: Aetna Government	$5.20
Rate for Payer: Brighton Health Commercial	$7.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.07
Rate for Payer: Group Health Inc Commercial	$5.20
Rate for Payer: Group Health Inc Medicare	$3.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.20
Rate for Payer: Hamaspik Choice Inc Medicare	$5.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.76

BALL COTTON STRUNG 5/8

Facility

$0.82

Hospital Charge Code	64903145
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.41
Rate for Payer: Aetna Government	$0.41
Rate for Payer: Brighton Health Commercial	$0.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.56
Rate for Payer: Group Health Inc Commercial	$0.41
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.41
Rate for Payer: Hamaspik Choice Inc Medicare	$0.41

BALL MONOPOLAR COAG 3MM 24 FR

Facility

$358.06

Hospital Charge Code	64906760
Hospital Revenue Code	279
Min. Negotiated Rate	$125.32
Max. Negotiated Rate	$286.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$196.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$179.03
Rate for Payer: Aetna Government	$179.03
Rate for Payer: Brighton Health Commercial	$268.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$286.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$243.48
Rate for Payer: Group Health Inc Commercial	$179.03
Rate for Payer: Group Health Inc Medicare	$125.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$179.03
Rate for Payer: Hamaspik Choice Inc Medicare	$179.03

BALLOON CATH N AB14

Facility

$687.50

Service Code	HCPCS C1725
Hospital Charge Code	64906976
Hospital Revenue Code	278
Min. Negotiated Rate	$343.75
Max. Negotiated Rate	$343.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$343.75
Rate for Payer: Hamaspik Choice Inc Medicare	$343.75

BALLOON CATH N AB14

Facility

$687.50

Service Code	HCPCS C1725
Hospital Charge Code	64906976
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$721.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$378.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$412.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$343.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$395.31
Rate for Payer: EmblemHealth Commercial	$343.75
Rate for Payer: Fidelis Medicare Advantage	$721.88
Rate for Payer: Group Health Inc Commercial	$343.75
Rate for Payer: Group Health Inc Medicare	$240.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$343.75
Rate for Payer: Hamaspik Choice Inc Medicare	$343.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$446.88

BALLOON DILATATION 10-4/5.8/180CM

Facility

$965.82

Hospital Charge Code	64904274
Hospital Revenue Code	270
Min. Negotiated Rate	$338.04
Max. Negotiated Rate	$772.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$531.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$482.91
Rate for Payer: Aetna Government	$482.91
Rate for Payer: Brighton Health Commercial	$724.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$772.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$656.76
Rate for Payer: Group Health Inc Commercial	$482.91
Rate for Payer: Group Health Inc Medicare	$338.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$482.91
Rate for Payer: Hamaspik Choice Inc Medicare	$482.91

BALLOON DILATATION 1.5-2X150-210M

Facility

$275.00

Hospital Charge Code	64906225
Hospital Revenue Code	270
Min. Negotiated Rate	$96.25
Max. Negotiated Rate	$220.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$137.50
Rate for Payer: Aetna Government	$137.50
Rate for Payer: Brighton Health Commercial	$206.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$220.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$187.00
Rate for Payer: Group Health Inc Commercial	$137.50
Rate for Payer: Group Health Inc Medicare	$96.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.50
Rate for Payer: Hamaspik Choice Inc Medicare	$137.50

BALLOON DILATATION 8-4/5.8/180CM

Facility

$646.95

Hospital Charge Code	64904276
Hospital Revenue Code	270
Min. Negotiated Rate	$226.43
Max. Negotiated Rate	$517.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$355.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$323.48
Rate for Payer: Aetna Government	$323.48
Rate for Payer: Brighton Health Commercial	$485.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$517.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$439.93
Rate for Payer: Group Health Inc Commercial	$323.48
Rate for Payer: Group Health Inc Medicare	$226.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$323.48
Rate for Payer: Hamaspik Choice Inc Medicare	$323.48

BALLOON DILATATION PTA 5X40X1.42M

Facility

$275.00

Hospital Charge Code	64906228
Hospital Revenue Code	270
Min. Negotiated Rate	$96.25
Max. Negotiated Rate	$220.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$137.50
Rate for Payer: Aetna Government	$137.50
Rate for Payer: Brighton Health Commercial	$206.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$220.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$187.00
Rate for Payer: Group Health Inc Commercial	$137.50
Rate for Payer: Group Health Inc Medicare	$96.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.50
Rate for Payer: Hamaspik Choice Inc Medicare	$137.50

BALLOON DILAT RIGIFLX ACHLSIA

Facility

$1,804.75

Hospital Charge Code	64907379
Hospital Revenue Code	270
Min. Negotiated Rate	$631.66
Max. Negotiated Rate	$1,443.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$992.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$902.38
Rate for Payer: Aetna Government	$902.38
Rate for Payer: Brighton Health Commercial	$1,353.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,443.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,227.23
Rate for Payer: Group Health Inc Commercial	$902.38
Rate for Payer: Group Health Inc Medicare	$631.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$902.38
Rate for Payer: Hamaspik Choice Inc Medicare	$902.38

BALLOON DISSCTR LAPRO BLNT TP

Facility

$1,420.20

Hospital Charge Code	64906857
Hospital Revenue Code	279
Min. Negotiated Rate	$497.07
Max. Negotiated Rate	$1,136.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$781.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$710.10
Rate for Payer: Aetna Government	$710.10
Rate for Payer: Brighton Health Commercial	$1,065.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,136.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$965.74
Rate for Payer: Group Health Inc Commercial	$710.10
Rate for Payer: Group Health Inc Medicare	$497.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$710.10
Rate for Payer: Hamaspik Choice Inc Medicare	$710.10

BALLOON DLT CRE 18-20 8CM F/G

Facility

$232.57

Hospital Charge Code	64906497
Hospital Revenue Code	270
Min. Negotiated Rate	$81.40
Max. Negotiated Rate	$186.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$127.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$116.28
Rate for Payer: Aetna Government	$116.28
Rate for Payer: Brighton Health Commercial	$174.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$186.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.15
Rate for Payer: Group Health Inc Commercial	$116.28
Rate for Payer: Group Health Inc Medicare	$81.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$116.28
Rate for Payer: Hamaspik Choice Inc Medicare	$116.28

BALLOON EUPX RX

Facility

$337.50

Service Code	HCPCS C1725
Hospital Charge Code	66520148
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$168.75
Rate for Payer: Hamaspik Choice Inc Medicare	$168.75

BALLOON EUPX RX

Facility

$337.50

Service Code	HCPCS C1725
Hospital Charge Code	66520148
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$354.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$185.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$202.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$194.06
Rate for Payer: EmblemHealth Commercial	$168.75
Rate for Payer: Fidelis Medicare Advantage	$354.38
Rate for Payer: Group Health Inc Commercial	$168.75
Rate for Payer: Group Health Inc Medicare	$118.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$168.75
Rate for Payer: Hamaspik Choice Inc Medicare	$168.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$219.38

Know your out-of-pocket cost for care.

All Charges