St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BARD PATCH HERNIA COMP/K LG OVAL

Facility

$1,268.50

Service Code	HCPCS C1781
Hospital Charge Code	40205619
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,331.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$697.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$761.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$634.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$729.39
Rate for Payer: EmblemHealth Commercial	$634.25
Rate for Payer: Fidelis Medicare Advantage	$1,331.92
Rate for Payer: Group Health Inc Commercial	$634.25
Rate for Payer: Group Health Inc Medicare	$443.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$634.25
Rate for Payer: Hamaspik Choice Inc Medicare	$634.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$824.52

BARD PATCH HERNIA COMP/K LG OVAL

Facility

$1,268.50

Service Code	HCPCS C1781
Hospital Charge Code	40205619
Hospital Revenue Code	278
Min. Negotiated Rate	$634.25
Max. Negotiated Rate	$634.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$634.25
Rate for Payer: Hamaspik Choice Inc Medicare	$634.25

BARD PATCH HERNIA COMP S OVAL

Facility

$2,872.00

Hospital Charge Code	40205797
Hospital Revenue Code	272
Min. Negotiated Rate	$1,005.20
Max. Negotiated Rate	$2,297.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,579.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,436.00
Rate for Payer: Aetna Government	$1,436.00
Rate for Payer: Brighton Health Commercial	$2,154.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,297.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,952.96
Rate for Payer: Group Health Inc Commercial	$1,436.00
Rate for Payer: Group Health Inc Medicare	$1,005.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,436.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,436.00

BARD PTCH HERN COMP KUGEL OVAL XL

Facility

$3,200.00

Service Code	HCPCS C1781
Hospital Charge Code	40206097
Hospital Revenue Code	278
Min. Negotiated Rate	$1,600.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,600.00

BARD PTCH HERN COMP KUGEL OVAL XL

Facility

$3,200.00

Service Code	HCPCS C1781
Hospital Charge Code	40206097
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$3,360.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,760.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,920.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,840.00
Rate for Payer: EmblemHealth Commercial	$1,600.00
Rate for Payer: Fidelis Medicare Advantage	$3,360.00
Rate for Payer: Group Health Inc Commercial	$1,600.00
Rate for Payer: Group Health Inc Medicare	$1,120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,600.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,080.00

BARD PTCH HERN COMP KUGEL SM 3X3

Facility

$2,014.00

Service Code	HCPCS C1781
Hospital Charge Code	40205009
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$2,114.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,107.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,208.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,007.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,158.05
Rate for Payer: EmblemHealth Commercial	$1,007.00
Rate for Payer: Fidelis Medicare Advantage	$2,114.70
Rate for Payer: Group Health Inc Commercial	$1,007.00
Rate for Payer: Group Health Inc Medicare	$704.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,007.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,007.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,309.10

BARD PTCH HERN COMP KUGEL SM 3X3

Facility

$2,014.00

Service Code	HCPCS C1781
Hospital Charge Code	40205009
Hospital Revenue Code	278
Min. Negotiated Rate	$1,007.00
Max. Negotiated Rate	$1,007.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,007.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,007.00

BARD PTH HERNIA V LG W/CIRCLE

Facility

$962.00

Hospital Charge Code	40205155
Hospital Revenue Code	272
Min. Negotiated Rate	$336.70
Max. Negotiated Rate	$769.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$529.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$481.00
Rate for Payer: Aetna Government	$481.00
Rate for Payer: Brighton Health Commercial	$721.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$769.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$654.16
Rate for Payer: Group Health Inc Commercial	$481.00
Rate for Payer: Group Health Inc Medicare	$336.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$481.00
Rate for Payer: Hamaspik Choice Inc Medicare	$481.00

BARD SITE RITE COVER W/GEL

Facility

$13.60

Hospital Charge Code	40206284
Hospital Revenue Code	270
Min. Negotiated Rate	$4.76
Max. Negotiated Rate	$10.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.80
Rate for Payer: Aetna Government	$6.80
Rate for Payer: Brighton Health Commercial	$10.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.25
Rate for Payer: Group Health Inc Commercial	$6.80
Rate for Payer: Group Health Inc Medicare	$4.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.80
Rate for Payer: Hamaspik Choice Inc Medicare	$6.80

BARD VENTRIO H/P 11.4CM X11.4CM

Facility

$2,179.84

Service Code	HCPCS C1781
Hospital Charge Code	40207041
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$2,288.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,198.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,307.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,089.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,253.41
Rate for Payer: EmblemHealth Commercial	$1,089.92
Rate for Payer: Fidelis Medicare Advantage	$2,288.83
Rate for Payer: Group Health Inc Commercial	$1,089.92
Rate for Payer: Group Health Inc Medicare	$762.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,089.92
Rate for Payer: Hamaspik Choice Inc Medicare	$1,089.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,416.90

BARD VENTRIO H/P 11.4CM X11.4CM

Facility

$2,179.84

Service Code	HCPCS C1781
Hospital Charge Code	40207041
Hospital Revenue Code	278
Min. Negotiated Rate	$1,089.92
Max. Negotiated Rate	$1,089.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,089.92
Rate for Payer: Hamaspik Choice Inc Medicare	$1,089.92

BARI AIR THERAPY SYSTEM

Facility

$200.00

Hospital Charge Code	40209311
Hospital Revenue Code	270
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$160.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.00
Rate for Payer: Aetna Government	$100.00
Rate for Payer: Brighton Health Commercial	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

BARIKARE BARIATRIC BED

Facility

$260.00

Hospital Charge Code	40209312
Hospital Revenue Code	270
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$208.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Brighton Health Commercial	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00

BARIMAXX II BED

Facility

$200.00

Hospital Charge Code	40209310
Hospital Revenue Code	270
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$160.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.00
Rate for Payer: Aetna Government	$100.00
Rate for Payer: Brighton Health Commercial	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

BARIUM SULFATE 2% SUSP 450 ML

Facility

$8.00

Hospital Charge Code	41644427
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

BARIUM SULFATE 2% SUSP 450 ML

Facility

$8.00

Hospital Charge Code	41654427
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

BARIUM SULFATE 2% SUSP 900 ML

Facility

$22.00

Hospital Charge Code	41653815
Hospital Revenue Code	250
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$17.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.00
Rate for Payer: Aetna Government	$11.00
Rate for Payer: Brighton Health Commercial	$16.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.96
Rate for Payer: Group Health Inc Commercial	$11.00
Rate for Payer: Group Health Inc Medicare	$7.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.30

BARIUM SULFATE 2% SUSP 900 ML

Facility

$22.00

Hospital Charge Code	41643815
Hospital Revenue Code	250
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$17.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.00
Rate for Payer: Aetna Government	$11.00
Rate for Payer: Brighton Health Commercial	$16.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.96
Rate for Payer: Group Health Inc Commercial	$11.00
Rate for Payer: Group Health Inc Medicare	$7.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.30

BARRIER ADHESION SEPRAFILM 5X6

Facility

$727.31

Hospital Charge Code	64903989
Hospital Revenue Code	270
Min. Negotiated Rate	$254.56
Max. Negotiated Rate	$581.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$400.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$363.66
Rate for Payer: Aetna Government	$363.66
Rate for Payer: Brighton Health Commercial	$545.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$581.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$494.57
Rate for Payer: Group Health Inc Commercial	$363.66
Rate for Payer: Group Health Inc Medicare	$254.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$363.66
Rate for Payer: Hamaspik Choice Inc Medicare	$363.66

BARRIER INTERCEED ABSORB ADH 3X4

Facility

$791.46

Hospital Charge Code	64904158
Hospital Revenue Code	270
Min. Negotiated Rate	$277.01
Max. Negotiated Rate	$633.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$435.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$395.73
Rate for Payer: Aetna Government	$395.73
Rate for Payer: Brighton Health Commercial	$593.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$633.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$538.19
Rate for Payer: Group Health Inc Commercial	$395.73
Rate for Payer: Group Health Inc Medicare	$277.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.73
Rate for Payer: Hamaspik Choice Inc Medicare	$395.73

BARRIER, NI, CTF,W/TAPE

Facility

$7.19

Hospital Charge Code	40201976
Hospital Revenue Code	270
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$5.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.60
Rate for Payer: Aetna Government	$3.60
Rate for Payer: Brighton Health Commercial	$5.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.89
Rate for Payer: Group Health Inc Commercial	$3.60
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60

BARRIER, NI, CTF, W/TAPE, 4FL

Facility

$35.95

Hospital Charge Code	64903928
Hospital Revenue Code	270
Min. Negotiated Rate	$12.58
Max. Negotiated Rate	$28.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.98
Rate for Payer: Aetna Government	$17.98
Rate for Payer: Brighton Health Commercial	$26.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.45
Rate for Payer: Group Health Inc Commercial	$17.98
Rate for Payer: Group Health Inc Medicare	$12.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.98
Rate for Payer: Hamaspik Choice Inc Medicare	$17.98

BARRIER OPST PST-OP VZ 25X10CM

Facility

$97.85

Hospital Charge Code	64906300
Hospital Revenue Code	270
Min. Negotiated Rate	$34.25
Max. Negotiated Rate	$78.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$48.92
Rate for Payer: Aetna Government	$48.92
Rate for Payer: Brighton Health Commercial	$73.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$78.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.54
Rate for Payer: Group Health Inc Commercial	$48.92
Rate for Payer: Group Health Inc Medicare	$34.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.92
Rate for Payer: Hamaspik Choice Inc Medicare	$48.92

BARRIER SKIN STOMA MEDIUM 2-1/4

Facility

$3.40

Hospital Charge Code	64901334
Hospital Revenue Code	270
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$2.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$2.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.31
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70

BARRIER, SKIN STOMA MEDIUM 2-1/4

Facility

$1.20

Hospital Charge Code	40201978
Hospital Revenue Code	270
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.60
Rate for Payer: Aetna Government	$0.60
Rate for Payer: Brighton Health Commercial	$0.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.82
Rate for Payer: Group Health Inc Commercial	$0.60
Rate for Payer: Group Health Inc Medicare	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.60
Rate for Payer: Hamaspik Choice Inc Medicare	$0.60

Know your out-of-pocket cost for care.

All Charges