St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SET CUFFED EMERG CRICOTHYR 5F 9C

Facility

$614.58

Hospital Charge Code	64903272
Hospital Revenue Code	270
Min. Negotiated Rate	$215.10
Max. Negotiated Rate	$491.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$338.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$307.29
Rate for Payer: Aetna Government	$307.29
Rate for Payer: Brighton Health Commercial	$460.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$491.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$417.91
Rate for Payer: Group Health Inc Commercial	$307.29
Rate for Payer: Group Health Inc Medicare	$215.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.29
Rate for Payer: Hamaspik Choice Inc Medicare	$307.29

SET CYLINDER W/PUMP SCROTAL

Facility

$18,550.00

Service Code	HCPCS C1813
Hospital Charge Code	64902756
Hospital Revenue Code	278
Min. Negotiated Rate	$9,275.00
Max. Negotiated Rate	$9,275.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9,275.00

SET CYLINDER W/PUMP SCROTAL

Facility

$18,550.00

Service Code	HCPCS C1813
Hospital Charge Code	64902756
Hospital Revenue Code	278
Min. Negotiated Rate	$3,775.00
Max. Negotiated Rate	$19,477.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10,202.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,775.00
Rate for Payer: Aetna Government	$3,775.00
Rate for Payer: Brighton Health Commercial	$11,130.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9,275.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$10,666.25
Rate for Payer: EmblemHealth Commercial	$9,275.00
Rate for Payer: Fidelis Medicare Advantage	$19,477.50
Rate for Payer: Group Health Inc Commercial	$9,275.00
Rate for Payer: Group Health Inc Medicare	$6,492.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9,275.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,057.50

SET DISPOSABLE COLLECTION

Facility

$22.87

Hospital Charge Code	64902764
Hospital Revenue Code	270
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$18.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.44
Rate for Payer: Aetna Government	$11.44
Rate for Payer: Brighton Health Commercial	$17.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.55
Rate for Payer: Group Health Inc Commercial	$11.44
Rate for Payer: Group Health Inc Medicare	$8.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.44
Rate for Payer: Hamaspik Choice Inc Medicare	$11.44

SET EPIDURAL SPIKE A

Facility

$12.19

Hospital Charge Code	64901789
Hospital Revenue Code	270
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$9.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.10
Rate for Payer: Aetna Government	$6.10
Rate for Payer: Brighton Health Commercial	$9.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.29
Rate for Payer: Group Health Inc Commercial	$6.10
Rate for Payer: Group Health Inc Medicare	$4.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.10
Rate for Payer: Hamaspik Choice Inc Medicare	$6.10

SET EPIDURAL SPIKE B

Facility

$20.07

Hospital Charge Code	64902534
Hospital Revenue Code	270
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$16.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.04
Rate for Payer: Aetna Government	$10.04
Rate for Payer: Brighton Health Commercial	$15.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.65
Rate for Payer: Group Health Inc Commercial	$10.04
Rate for Payer: Group Health Inc Medicare	$7.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.04
Rate for Payer: Hamaspik Choice Inc Medicare	$10.04

SET,EXTENSION,60,MICRO VOLUME

Facility

$2.08

Hospital Charge Code	64902339
Hospital Revenue Code	270
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$1.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.04
Rate for Payer: Aetna Government	$1.04
Rate for Payer: Brighton Health Commercial	$1.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.41
Rate for Payer: Group Health Inc Commercial	$1.04
Rate for Payer: Group Health Inc Medicare	$0.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.04
Rate for Payer: Hamaspik Choice Inc Medicare	$1.04

SET, EXTENTION, CATH MICROBORE

Facility

$7.21

Hospital Charge Code	64901314
Hospital Revenue Code	279
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$5.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.60
Rate for Payer: Aetna Government	$3.60
Rate for Payer: Brighton Health Commercial	$5.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.90
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

SET, EXT, MCROBR, CATH, IV CONT

Facility

$3.51

Hospital Charge Code	64902306
Hospital Revenue Code	279
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$2.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.76
Rate for Payer: Aetna Government	$1.76
Rate for Payer: Brighton Health Commercial	$2.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.39
Rate for Payer: Group Health Inc Commercial	$1.76
Rate for Payer: Group Health Inc Medicare	$1.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.76
Rate for Payer: Hamaspik Choice Inc Medicare	$1.76

SET EXT PERIPHERAL FEM LUER

Facility

$1.56

Hospital Charge Code	64904566
Hospital Revenue Code	270
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$1.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.78
Rate for Payer: Aetna Government	$0.78
Rate for Payer: Brighton Health Commercial	$1.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.06
Rate for Payer: Group Health Inc Commercial	$0.78
Rate for Payer: Group Health Inc Medicare	$0.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.78
Rate for Payer: Hamaspik Choice Inc Medicare	$0.78

SET, EXT, STAND BORE, CATH, NEDL

Facility

$1.84

Hospital Charge Code	64902191
Hospital Revenue Code	279
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$1.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.92
Rate for Payer: Aetna Government	$0.92
Rate for Payer: Brighton Health Commercial	$1.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.25
Rate for Payer: Group Health Inc Commercial	$0.92
Rate for Payer: Group Health Inc Medicare	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.92
Rate for Payer: Hamaspik Choice Inc Medicare	$0.92

SET FEED PUMP FORMULA,W WATER

Facility

$18.74

Hospital Charge Code	64901104
Hospital Revenue Code	270
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$14.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.37
Rate for Payer: Aetna Government	$9.37
Rate for Payer: Brighton Health Commercial	$14.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.74
Rate for Payer: Group Health Inc Commercial	$9.37
Rate for Payer: Group Health Inc Medicare	$6.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.37
Rate for Payer: Hamaspik Choice Inc Medicare	$9.37

SET FEED PUMP SPIKE W WATER BAG

Facility

$376.60

Hospital Charge Code	64901456
Hospital Revenue Code	270
Min. Negotiated Rate	$131.81
Max. Negotiated Rate	$301.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$207.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$188.30
Rate for Payer: Aetna Government	$188.30
Rate for Payer: Brighton Health Commercial	$282.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$301.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$256.09
Rate for Payer: Group Health Inc Commercial	$188.30
Rate for Payer: Group Health Inc Medicare	$131.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$188.30
Rate for Payer: Hamaspik Choice Inc Medicare	$188.30

SET FEED PUMP SPIKE W/WATER BAG

Facility

$13.48

Hospital Charge Code	64901103
Hospital Revenue Code	270
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$10.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.74
Rate for Payer: Aetna Government	$6.74
Rate for Payer: Brighton Health Commercial	$10.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.17
Rate for Payer: Group Health Inc Commercial	$6.74
Rate for Payer: Group Health Inc Medicare	$4.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.74
Rate for Payer: Hamaspik Choice Inc Medicare	$6.74

SET FISTULA ARTERIOVENUS 5M564

Facility

$1.00

Hospital Charge Code	40209472
Hospital Revenue Code	270
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50

SET FLUID WARMING ADMINISTRATION

Facility

$173.45

Hospital Charge Code	64902524
Hospital Revenue Code	270
Min. Negotiated Rate	$60.71
Max. Negotiated Rate	$138.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$95.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$86.72
Rate for Payer: Aetna Government	$86.72
Rate for Payer: Brighton Health Commercial	$130.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$138.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$117.95
Rate for Payer: Group Health Inc Commercial	$86.72
Rate for Payer: Group Health Inc Medicare	$60.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.72
Rate for Payer: Hamaspik Choice Inc Medicare	$86.72

SET GENESYS PROCEDURE HTA

Facility

$3,650.00

Hospital Charge Code	64904403
Hospital Revenue Code	270
Min. Negotiated Rate	$1,277.50
Max. Negotiated Rate	$2,920.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,007.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,825.00
Rate for Payer: Aetna Government	$1,825.00
Rate for Payer: Brighton Health Commercial	$2,737.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,920.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,482.00
Rate for Payer: Group Health Inc Commercial	$1,825.00
Rate for Payer: Group Health Inc Medicare	$1,277.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,825.00

SET GENESYS PROCEVA 80210

Facility

$3,819.24

Hospital Charge Code	64906778
Hospital Revenue Code	279
Min. Negotiated Rate	$1,336.73
Max. Negotiated Rate	$3,055.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,100.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,909.62
Rate for Payer: Aetna Government	$1,909.62
Rate for Payer: Brighton Health Commercial	$2,864.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,055.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,597.08
Rate for Payer: Group Health Inc Commercial	$1,909.62
Rate for Payer: Group Health Inc Medicare	$1,336.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,909.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,909.62

SET INSERT FOGARTY SOFTJAW

Facility

$37.18

Hospital Charge Code	64903980
Hospital Revenue Code	270
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$29.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.59
Rate for Payer: Aetna Government	$18.59
Rate for Payer: Brighton Health Commercial	$27.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.28
Rate for Payer: Group Health Inc Commercial	$18.59
Rate for Payer: Group Health Inc Medicare	$13.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.59
Rate for Payer: Hamaspik Choice Inc Medicare	$18.59

SET INTRO CATH 16FR

Facility

$102.75

Service Code	HCPCS C1894
Hospital Charge Code	64903576
Hospital Revenue Code	279
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$82.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.82
Rate for Payer: Aetna Government	$0.82
Rate for Payer: Brighton Health Commercial	$77.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$82.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.87
Rate for Payer: Group Health Inc Commercial	$51.38
Rate for Payer: Group Health Inc Medicare	$35.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.38
Rate for Payer: Hamaspik Choice Inc Medicare	$51.38

SET INTRO CATH 18FR

Facility

$102.75

Service Code	HCPCS C1894
Hospital Charge Code	64903574
Hospital Revenue Code	279
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$82.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.82
Rate for Payer: Aetna Government	$0.82
Rate for Payer: Brighton Health Commercial	$77.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$82.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.87
Rate for Payer: Group Health Inc Commercial	$51.38
Rate for Payer: Group Health Inc Medicare	$35.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.38
Rate for Payer: Hamaspik Choice Inc Medicare	$51.38

SET INTRO CATH 20FR 13

Facility

$98.88

Service Code	HCPCS C1894
Hospital Charge Code	64903572
Hospital Revenue Code	279
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$79.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$54.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.82
Rate for Payer: Aetna Government	$0.82
Rate for Payer: Brighton Health Commercial	$74.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.24
Rate for Payer: Group Health Inc Commercial	$49.44
Rate for Payer: Group Health Inc Medicare	$34.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.44
Rate for Payer: Hamaspik Choice Inc Medicare	$49.44

SET INTRODUCER OVAL PULL-APART

Facility

$739.48

Hospital Charge Code	64902688
Hospital Revenue Code	270
Min. Negotiated Rate	$258.82
Max. Negotiated Rate	$591.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$406.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$369.74
Rate for Payer: Aetna Government	$369.74
Rate for Payer: Brighton Health Commercial	$554.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$591.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$502.85
Rate for Payer: Group Health Inc Commercial	$369.74
Rate for Payer: Group Health Inc Medicare	$258.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$369.74
Rate for Payer: Hamaspik Choice Inc Medicare	$369.74

SET INTRODUCER TEAR-AWAY 9FR

Facility

$146.72

Hospital Charge Code	64904178
Hospital Revenue Code	270
Min. Negotiated Rate	$51.35
Max. Negotiated Rate	$117.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.36
Rate for Payer: Aetna Government	$73.36
Rate for Payer: Brighton Health Commercial	$110.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$117.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.77
Rate for Payer: Group Health Inc Commercial	$73.36
Rate for Payer: Group Health Inc Medicare	$51.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.36
Rate for Payer: Hamaspik Choice Inc Medicare	$73.36

SET INTRODUCR 4FR MICROPUNC

Facility

$68.90

Hospital Charge Code	64903154
Hospital Revenue Code	270
Min. Negotiated Rate	$24.12
Max. Negotiated Rate	$55.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.45
Rate for Payer: Aetna Government	$34.45
Rate for Payer: Brighton Health Commercial	$51.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.85
Rate for Payer: Group Health Inc Commercial	$34.45
Rate for Payer: Group Health Inc Medicare	$24.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.45
Rate for Payer: Hamaspik Choice Inc Medicare	$34.45

Know your out-of-pocket cost for care.

All Charges