St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ MEDLINE 1000ML PRESSURE INFUSE

Facility OP

$20.50

Hospital Charge Code	41566954
Hospital Revenue Code	272
Min. Negotiated Rate	$7.18
Max. Negotiated Rate	$16.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.25
Rate for Payer: Aetna Government	$10.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.94
Rate for Payer: Group Health Inc Commercial	$10.25
Rate for Payer: Group Health Inc Medicare	$7.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.25
Rate for Payer: Hamaspik Choice Inc Medicare	$10.25

ZZ MEDRAD ANGIOJET 6F/120CM

Facility OP

$3,460.00

Hospital Charge Code	41561957
Hospital Revenue Code	270
Min. Negotiated Rate	$1,211.00
Max. Negotiated Rate	$2,768.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,903.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,730.00
Rate for Payer: Aetna Government	$1,730.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,768.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,352.80
Rate for Payer: Group Health Inc Commercial	$1,730.00
Rate for Payer: Group Health Inc Medicare	$1,211.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,730.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,730.00

ZZ MEDTRONIC KYPHON BONE BX DEV

Facility OP

$280.00

Hospital Charge Code	41544800
Hospital Revenue Code	272
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$224.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$140.00
Rate for Payer: Aetna Government	$140.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$224.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$190.40
Rate for Payer: Group Health Inc Commercial	$140.00
Rate for Payer: Group Health Inc Medicare	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00

ZZ MEDTRONIC KYPHON BONE CEMENT/M

Facility OP

$210.00

Hospital Charge Code	41540601
Hospital Revenue Code	272
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.00
Rate for Payer: Aetna Government	$105.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.80
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00

ZZ MEDTRONIC KYPHON EXP CURETTE

Facility OP

$495.00

Hospital Charge Code	41540600
Hospital Revenue Code	272
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$396.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$247.50
Rate for Payer: Aetna Government	$247.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$396.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$336.60
Rate for Payer: Group Health Inc Commercial	$247.50
Rate for Payer: Group Health Inc Medicare	$173.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.50
Rate for Payer: Hamaspik Choice Inc Medicare	$247.50

ZZ MEDTRONIC KYPHON EXPRESS TRAY

Facility OP

$3,925.00

Hospital Charge Code	41540602
Hospital Revenue Code	272
Min. Negotiated Rate	$1,373.75
Max. Negotiated Rate	$3,140.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,158.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,962.50
Rate for Payer: Aetna Government	$1,962.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,140.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,669.00
Rate for Payer: Group Health Inc Commercial	$1,962.50
Rate for Payer: Group Health Inc Medicare	$1,373.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,962.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,962.50

ZZ MERIT DRAINAGE BAG

Facility OP

$21.00

Hospital Charge Code	41567758
Hospital Revenue Code	270
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$16.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.50
Rate for Payer: Aetna Government	$10.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.28
Rate for Payer: Group Health Inc Commercial	$10.50
Rate for Payer: Group Health Inc Medicare	$7.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.50
Rate for Payer: Hamaspik Choice Inc Medicare	$10.50

ZZ MERIT PICC LINE SUPPLIES

Facility OP

$126.00

Hospital Charge Code	41561350
Hospital Revenue Code	272
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$100.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.00
Rate for Payer: Aetna Government	$63.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.68
Rate for Payer: Group Health Inc Commercial	$63.00
Rate for Payer: Group Health Inc Medicare	$44.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.00
Rate for Payer: Hamaspik Choice Inc Medicare	$63.00

ZZ MERIT THORA/PARAC SET

Facility OP

$90.00

Hospital Charge Code	41561927
Hospital Revenue Code	270
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

ZZ MEWISSEN 5/35/10/100

Facility OP

$228.22

Hospital Charge Code	41567248
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MEWISSEN 5/35/10/65

Facility OP

$228.22

Hospital Charge Code	41567251
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MEWISSEN 5/35/15/100

Facility OP

$228.22

Hospital Charge Code	41567256
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MEWISSEN 5/35/5/100

Facility OP

$228.22

Hospital Charge Code	41567249
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MEWISSEN 5/35/5/65

Facility OP

$228.22

Hospital Charge Code	41567250
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MICROCATH 3-2.3F 20 100

Facility OP

$489.04

Hospital Charge Code	41567351
Hospital Revenue Code	270
Min. Negotiated Rate	$171.16
Max. Negotiated Rate	$391.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$244.52
Rate for Payer: Aetna Government	$244.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$391.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$332.55
Rate for Payer: Group Health Inc Commercial	$244.52
Rate for Payer: Group Health Inc Medicare	$171.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$244.52
Rate for Payer: Hamaspik Choice Inc Medicare	$244.52

ZZ MICROCATH 3-2.3F 20 135

Facility OP

$489.04

Hospital Charge Code	41567352
Hospital Revenue Code	270
Min. Negotiated Rate	$171.16
Max. Negotiated Rate	$391.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$244.52
Rate for Payer: Aetna Government	$244.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$391.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$332.55
Rate for Payer: Group Health Inc Commercial	$244.52
Rate for Payer: Group Health Inc Medicare	$171.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$244.52
Rate for Payer: Hamaspik Choice Inc Medicare	$244.52

ZZ MICROCATH 3-2.3F 20 150

Facility OP

$489.04

Hospital Charge Code	41567350
Hospital Revenue Code	270
Min. Negotiated Rate	$171.16
Max. Negotiated Rate	$391.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$244.52
Rate for Payer: Aetna Government	$244.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$391.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$332.55
Rate for Payer: Group Health Inc Commercial	$244.52
Rate for Payer: Group Health Inc Medicare	$171.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$244.52
Rate for Payer: Hamaspik Choice Inc Medicare	$244.52

ZZ MICROCOILS

Facility OP

$189.24

Service Code	HCPCS C1884
Hospital Charge Code	41560057
Hospital Revenue Code	278
Min. Negotiated Rate	$66.23
Max. Negotiated Rate	$198.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$94.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.81
Rate for Payer: Fidelis Medicare Advantage	$198.70
Rate for Payer: Group Health Inc Commercial	$94.62
Rate for Payer: Group Health Inc Medicare	$66.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.62
Rate for Payer: Hamaspik Choice Inc Medicare	$94.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$123.01

ZZ MICROCOILS

Facility IP

$189.24

Service Code	HCPCS C1884
Hospital Charge Code	41560057
Hospital Revenue Code	278
Min. Negotiated Rate	$94.62
Max. Negotiated Rate	$94.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.62
Rate for Payer: Hamaspik Choice Inc Medicare	$94.62

ZZ MICROCOILS 18 2/10

Facility OP

$189.24

Hospital Charge Code	41567158
Hospital Revenue Code	270
Min. Negotiated Rate	$66.23
Max. Negotiated Rate	$151.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$94.62
Rate for Payer: Aetna Government	$94.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$151.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.68
Rate for Payer: Group Health Inc Commercial	$94.62
Rate for Payer: Group Health Inc Medicare	$66.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.62
Rate for Payer: Hamaspik Choice Inc Medicare	$94.62

ZZ MICROCOIL TORN

Facility OP

$247.71

Service Code	HCPCS C1884
Hospital Charge Code	41560056
Hospital Revenue Code	278
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$260.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$123.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.43
Rate for Payer: Fidelis Medicare Advantage	$260.10
Rate for Payer: Group Health Inc Commercial	$123.86
Rate for Payer: Group Health Inc Medicare	$86.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$161.01

ZZ MICROCOIL TORN

Facility IP

$247.71

Service Code	HCPCS C1884
Hospital Charge Code	41560056
Hospital Revenue Code	278
Min. Negotiated Rate	$123.86
Max. Negotiated Rate	$123.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86

ZZ MICROCOIL TORN 18S 3/2

Facility OP

$247.71

Hospital Charge Code	41567134
Hospital Revenue Code	270
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$198.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$123.86
Rate for Payer: Aetna Government	$123.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.44
Rate for Payer: Group Health Inc Commercial	$123.86
Rate for Payer: Group Health Inc Medicare	$86.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86

ZZ MICROCOIL TORN 18S 4/2

Facility OP

$247.71

Hospital Charge Code	41567135
Hospital Revenue Code	270
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$198.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$123.86
Rate for Payer: Aetna Government	$123.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.44
Rate for Payer: Group Health Inc Commercial	$123.86
Rate for Payer: Group Health Inc Medicare	$86.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86

ZZ MICROCOIL TORN 18S 5/2

Facility OP

$247.71

Hospital Charge Code	41567136
Hospital Revenue Code	270
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$198.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$123.86
Rate for Payer: Aetna Government	$123.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.44
Rate for Payer: Group Health Inc Commercial	$123.86
Rate for Payer: Group Health Inc Medicare	$86.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86

Price Transparency.

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