St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SET,IRRIGA,BLADDER/TUR,Y-TYPE,81

Facility

$16.20

Hospital Charge Code	64902562
Hospital Revenue Code	270
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$12.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.10
Rate for Payer: Aetna Government	$8.10
Rate for Payer: Brighton Health Commercial	$12.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.02
Rate for Payer: Group Health Inc Commercial	$8.10
Rate for Payer: Group Health Inc Medicare	$5.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.10
Rate for Payer: Hamaspik Choice Inc Medicare	$8.10

SET,IRRIGA,CYSTO/BLADDR,81

Facility

$8.04

Hospital Charge Code	64902559
Hospital Revenue Code	270
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$6.43
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	$6.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.47
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

SET, IRRIGATION UROLOGY 2 BG 94

Facility

$7.09

Hospital Charge Code	64902136
Hospital Revenue Code	270
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$5.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.54
Rate for Payer: Aetna Government	$3.54
Rate for Payer: Brighton Health Commercial	$5.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.82
Rate for Payer: Group Health Inc Commercial	$3.54
Rate for Payer: Group Health Inc Medicare	$2.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.54
Rate for Payer: Hamaspik Choice Inc Medicare	$3.54

SET IV CLEARLINK MED LL

Facility

$2.39

Hospital Charge Code	64901810
Hospital Revenue Code	270
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$1.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.20
Rate for Payer: Aetna Government	$1.20
Rate for Payer: Brighton Health Commercial	$1.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.63
Rate for Payer: Group Health Inc Commercial	$1.20
Rate for Payer: Group Health Inc Medicare	$0.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1.20

SET IV CLEARLINK VENTED 92

Facility

$7.63

Hospital Charge Code	64901808
Hospital Revenue Code	270
Min. Negotiated Rate	$2.67
Max. Negotiated Rate	$6.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.82
Rate for Payer: Aetna Government	$3.82
Rate for Payer: Brighton Health Commercial	$5.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.19
Rate for Payer: Group Health Inc Commercial	$3.82
Rate for Payer: Group Health Inc Medicare	$2.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.82
Rate for Payer: Hamaspik Choice Inc Medicare	$3.82

SET-MBO,ADMIN,CADD,78,BAG

Facility

$19.30

Hospital Charge Code	64901791
Hospital Revenue Code	270
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$15.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.65
Rate for Payer: Aetna Government	$9.65
Rate for Payer: Brighton Health Commercial	$14.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.12
Rate for Payer: Group Health Inc Commercial	$9.65
Rate for Payer: Group Health Inc Medicare	$6.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.65
Rate for Payer: Hamaspik Choice Inc Medicare	$9.65

SET MICRO VOLUME EXTENSION

Facility

$2.10

Hospital Charge Code	64902294
Hospital Revenue Code	270
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$1.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.05
Rate for Payer: Aetna Government	$1.05
Rate for Payer: Brighton Health Commercial	$1.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.43
Rate for Payer: Group Health Inc Commercial	$1.05
Rate for Payer: Group Health Inc Medicare	$0.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.05
Rate for Payer: Hamaspik Choice Inc Medicare	$1.05

SET NEEDLE EZ-IO 15MM

Facility

$287.50

Hospital Charge Code	64904874
Hospital Revenue Code	270
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$230.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$143.75
Rate for Payer: Aetna Government	$143.75
Rate for Payer: Brighton Health Commercial	$215.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: Group Health Inc Commercial	$143.75
Rate for Payer: Group Health Inc Medicare	$100.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.75
Rate for Payer: Hamaspik Choice Inc Medicare	$143.75

SET NEEDLE EZ-IO 25MM

Facility

$312.50

Hospital Charge Code	64904871
Hospital Revenue Code	270
Min. Negotiated Rate	$109.38
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$171.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$156.25
Rate for Payer: Aetna Government	$156.25
Rate for Payer: Brighton Health Commercial	$234.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$212.50
Rate for Payer: Group Health Inc Commercial	$156.25
Rate for Payer: Group Health Inc Medicare	$109.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$156.25
Rate for Payer: Hamaspik Choice Inc Medicare	$156.25

SET NEEDLE EZ-IO 45MM

Facility

$312.50

Hospital Charge Code	64904879
Hospital Revenue Code	270
Min. Negotiated Rate	$109.38
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$171.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$156.25
Rate for Payer: Aetna Government	$156.25
Rate for Payer: Brighton Health Commercial	$234.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$212.50
Rate for Payer: Group Health Inc Commercial	$156.25
Rate for Payer: Group Health Inc Medicare	$109.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$156.25
Rate for Payer: Hamaspik Choice Inc Medicare	$156.25

SET,NITROGLYCERIN,INTERLK,VNTD

Facility

$13.29

Hospital Charge Code	64902313
Hospital Revenue Code	270
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$10.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.64
Rate for Payer: Aetna Government	$6.64
Rate for Payer: Brighton Health Commercial	$9.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.04
Rate for Payer: Group Health Inc Commercial	$6.64
Rate for Payer: Group Health Inc Medicare	$4.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.64
Rate for Payer: Hamaspik Choice Inc Medicare	$6.64

SET PROCEDURE HTA

Facility

$2,400.00

Hospital Charge Code	40206068
Hospital Revenue Code	270
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,920.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,200.00
Rate for Payer: Aetna Government	$1,200.00
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,920.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,632.00
Rate for Payer: Group Health Inc Commercial	$1,200.00
Rate for Payer: Group Health Inc Medicare	$840.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.00

SET,PUMP,1000ML BAG,ENFIT

Facility

$4.02

Hospital Charge Code	64902088
Hospital Revenue Code	270
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$3.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.01
Rate for Payer: Aetna Government	$2.01
Rate for Payer: Brighton Health Commercial	$3.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.73
Rate for Payer: Group Health Inc Commercial	$2.01
Rate for Payer: Group Health Inc Medicare	$1.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.01
Rate for Payer: Hamaspik Choice Inc Medicare	$2.01

SET RING EXTERNAL FIXATION 2/3

Facility

$3,330.25

Hospital Charge Code	64905984
Hospital Revenue Code	270
Min. Negotiated Rate	$1,165.59
Max. Negotiated Rate	$2,664.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,831.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,665.12
Rate for Payer: Aetna Government	$1,665.12
Rate for Payer: Brighton Health Commercial	$2,497.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,664.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,264.57
Rate for Payer: Group Health Inc Commercial	$1,665.12
Rate for Payer: Group Health Inc Medicare	$1,165.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,665.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,665.12

SET SCREW

Facility

$280.00

Service Code	HCPCS C1713
Hospital Charge Code	40202057
Hospital Revenue Code	278
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$294.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$168.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$140.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.00
Rate for Payer: EmblemHealth Commercial	$140.00
Rate for Payer: Fidelis Medicare Advantage	$294.00
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$182.00

SET SCREW

Facility

$280.00

Service Code	HCPCS C1713
Hospital Charge Code	40202057
Hospital Revenue Code	278
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00

SET, SCROTAL, ZERO D, ANG W/PUMP

Facility

$22,700.00

Service Code	HCPCS C1813
Hospital Charge Code	64905525
Hospital Revenue Code	278
Min. Negotiated Rate	$3,775.00
Max. Negotiated Rate	$23,835.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,775.00
Rate for Payer: Aetna Government	$3,775.00
Rate for Payer: Brighton Health Commercial	$13,620.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11,350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13,052.50
Rate for Payer: EmblemHealth Commercial	$11,350.00
Rate for Payer: Fidelis Medicare Advantage	$23,835.00
Rate for Payer: Group Health Inc Commercial	$11,350.00
Rate for Payer: Group Health Inc Medicare	$7,945.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14,755.00

SET, SCROTAL, ZERO D, ANG W/PUMP

Facility

$22,700.00

Service Code	HCPCS C1813
Hospital Charge Code	64905525
Hospital Revenue Code	278
Min. Negotiated Rate	$11,350.00
Max. Negotiated Rate	$11,350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,350.00

SET SNOVA W HYPERINFL ADLT LARGE

Facility

$2,000.00

Hospital Charge Code	64903848
Hospital Revenue Code	270
Min. Negotiated Rate	$700.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,000.00
Rate for Payer: Aetna Government	$1,000.00
Rate for Payer: Brighton Health Commercial	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,360.00
Rate for Payer: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

SET SNOVA W HYPERINFL ADLT MED

Facility

$2,000.00

Hospital Charge Code	64903850
Hospital Revenue Code	270
Min. Negotiated Rate	$700.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,000.00
Rate for Payer: Aetna Government	$1,000.00
Rate for Payer: Brighton Health Commercial	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,360.00
Rate for Payer: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

SET,SOLUTION,CLEARLINK,BUR,DEHP

Facility

$17.01

Hospital Charge Code	64901302
Hospital Revenue Code	270
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$13.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.50
Rate for Payer: Aetna Government	$8.50
Rate for Payer: Brighton Health Commercial	$12.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.57
Rate for Payer: Group Health Inc Commercial	$8.50
Rate for Payer: Group Health Inc Medicare	$5.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.50
Rate for Payer: Hamaspik Choice Inc Medicare	$8.50

SET,SOLUTION,CONTINU-FLO,3

Facility

$7.90

Hospital Charge Code	64904778
Hospital Revenue Code	270
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$6.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.95
Rate for Payer: Aetna Government	$3.95
Rate for Payer: Brighton Health Commercial	$5.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.37
Rate for Payer: Group Health Inc Commercial	$3.95
Rate for Payer: Group Health Inc Medicare	$2.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.95
Rate for Payer: Hamaspik Choice Inc Medicare	$3.95

SET,SOLUTION,DUO,SPIKE,10DR/ML,9

Facility

$5.64

Hospital Charge Code	64901287
Hospital Revenue Code	270
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$4.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.82
Rate for Payer: Aetna Government	$2.82
Rate for Payer: Brighton Health Commercial	$4.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.84
Rate for Payer: Group Health Inc Commercial	$2.82
Rate for Payer: Group Health Inc Medicare	$1.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.82
Rate for Payer: Hamaspik Choice Inc Medicare	$2.82

SET,SOLUTION,VENTED,LUER ACTIV

Facility

$7.06

Hospital Charge Code	64901291
Hospital Revenue Code	270
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$5.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.53
Rate for Payer: Aetna Government	$3.53
Rate for Payer: Brighton Health Commercial	$5.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.80
Rate for Payer: Group Health Inc Commercial	$3.53
Rate for Payer: Group Health Inc Medicare	$2.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.53
Rate for Payer: Hamaspik Choice Inc Medicare	$3.53

SET SUTURE ANCHOR COPE GASTRO

Facility

$165.03

Hospital Charge Code	64904467
Hospital Revenue Code	270
Min. Negotiated Rate	$57.76
Max. Negotiated Rate	$132.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$82.52
Rate for Payer: Aetna Government	$82.52
Rate for Payer: Brighton Health Commercial	$123.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$132.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.22
Rate for Payer: Group Health Inc Commercial	$82.52
Rate for Payer: Group Health Inc Medicare	$57.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.52
Rate for Payer: Hamaspik Choice Inc Medicare	$82.52

Know your out-of-pocket cost for care.

All Charges