St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SHEATH FLEX BALKN GUIDE 6.0X40CM

Facility

$125.75

Hospital Charge Code	64904717
Hospital Revenue Code	270
Min. Negotiated Rate	$44.01
Max. Negotiated Rate	$100.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.88
Rate for Payer: Aetna Government	$62.88
Rate for Payer: Brighton Health Commercial	$94.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.51
Rate for Payer: Group Health Inc Commercial	$62.88
Rate for Payer: Group Health Inc Medicare	$44.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.88
Rate for Payer: Hamaspik Choice Inc Medicare	$62.88

SHEATH GUIDING 6F SHUTTLE SELECT

Facility

$250.00

Hospital Charge Code	64905610
Hospital Revenue Code	270
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$137.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$125.00
Rate for Payer: Aetna Government	$125.00
Rate for Payer: Brighton Health Commercial	$187.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$170.00
Rate for Payer: Group Health Inc Commercial	$125.00
Rate for Payer: Group Health Inc Medicare	$87.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$125.00

SHEATH INTROD TEAR AWAY 11F X 14

Facility

$17.41

Hospital Charge Code	64904148
Hospital Revenue Code	270
Min. Negotiated Rate	$6.09
Max. Negotiated Rate	$13.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.70
Rate for Payer: Aetna Government	$8.70
Rate for Payer: Brighton Health Commercial	$13.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.84
Rate for Payer: Group Health Inc Commercial	$8.70
Rate for Payer: Group Health Inc Medicare	$6.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.70
Rate for Payer: Hamaspik Choice Inc Medicare	$8.70

SHEATH INTRODUCER 5FR 2.5/10CM

Facility

$190.00

Hospital Charge Code	64906775
Hospital Revenue Code	270
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$152.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$95.00
Rate for Payer: Aetna Government	$95.00
Rate for Payer: Brighton Health Commercial	$142.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$152.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.20
Rate for Payer: Group Health Inc Commercial	$95.00
Rate for Payer: Group Health Inc Medicare	$66.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00

SHEATH INTRODUCER PERIPH 16FR

Facility

$297.58

Hospital Charge Code	64904715
Hospital Revenue Code	270
Min. Negotiated Rate	$104.15
Max. Negotiated Rate	$238.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$163.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$148.79
Rate for Payer: Aetna Government	$148.79
Rate for Payer: Brighton Health Commercial	$223.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$238.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$202.35
Rate for Payer: Group Health Inc Commercial	$148.79
Rate for Payer: Group Health Inc Medicare	$104.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$148.79
Rate for Payer: Hamaspik Choice Inc Medicare	$148.79

SHEATH INTRODUCER TEAR AWAY

Facility

$150.00

Hospital Charge Code	40200973
Hospital Revenue Code	270
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

SHEATH INTRODUCER TEAR AWAY 7FR

Facility

$146.72

Hospital Charge Code	64904531
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

SHEATH INTRODUCER TEARAWAY SET9FR

Facility

$510.00

Hospital Charge Code	40200975
Hospital Revenue Code	270
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$408.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$280.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$255.00
Rate for Payer: Aetna Government	$255.00
Rate for Payer: Brighton Health Commercial	$382.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$408.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$346.80
Rate for Payer: Group Health Inc Commercial	$255.00
Rate for Payer: Group Health Inc Medicare	$178.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$255.00
Rate for Payer: Hamaspik Choice Inc Medicare	$255.00

SHEATH ROOBEE

Facility

$143.50

Hospital Charge Code	64905926
Hospital Revenue Code	270
Min. Negotiated Rate	$50.22
Max. Negotiated Rate	$114.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$78.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$71.75
Rate for Payer: Aetna Government	$71.75
Rate for Payer: Brighton Health Commercial	$107.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.58
Rate for Payer: Group Health Inc Commercial	$71.75
Rate for Payer: Group Health Inc Medicare	$50.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.75
Rate for Payer: Hamaspik Choice Inc Medicare	$71.75

SHEATH SAFE 7F TEARAWY VALVE W/PT

Facility

$187.50

Hospital Charge Code	64902621
Hospital Revenue Code	270
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$103.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$93.75
Rate for Payer: Aetna Government	$93.75
Rate for Payer: Brighton Health Commercial	$140.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.50
Rate for Payer: Group Health Inc Commercial	$93.75
Rate for Payer: Group Health Inc Medicare	$65.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.75
Rate for Payer: Hamaspik Choice Inc Medicare	$93.75

SHEATH SLIDE-ON FOR PENTAX

Facility

$42.50

Hospital Charge Code	64902711
Hospital Revenue Code	270
Min. Negotiated Rate	$14.88
Max. Negotiated Rate	$34.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.25
Rate for Payer: Aetna Government	$21.25
Rate for Payer: Brighton Health Commercial	$31.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.90
Rate for Payer: Group Health Inc Commercial	$21.25
Rate for Payer: Group Health Inc Medicare	$14.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.25
Rate for Payer: Hamaspik Choice Inc Medicare	$21.25

SHEATH TEAR AWAY INTRADYN 13FR

Facility

$189.39

Hospital Charge Code	64902880
Hospital Revenue Code	270
Min. Negotiated Rate	$66.29
Max. Negotiated Rate	$151.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$94.70
Rate for Payer: Aetna Government	$94.70
Rate for Payer: Brighton Health Commercial	$142.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$151.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.79
Rate for Payer: Group Health Inc Commercial	$94.70
Rate for Payer: Group Health Inc Medicare	$66.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.70
Rate for Payer: Hamaspik Choice Inc Medicare	$94.70

SHEATH TEAR AWAY INTRADYN 13FR

Facility

$514.00

Hospital Charge Code	40200976
Hospital Revenue Code	270
Min. Negotiated Rate	$179.90
Max. Negotiated Rate	$411.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$282.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$257.00
Rate for Payer: Aetna Government	$257.00
Rate for Payer: Brighton Health Commercial	$385.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$411.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$349.52
Rate for Payer: Group Health Inc Commercial	$257.00
Rate for Payer: Group Health Inc Medicare	$179.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$257.00
Rate for Payer: Hamaspik Choice Inc Medicare	$257.00

SHEATH TUNNELER ORG SCANLAN

Facility

$75.60

Hospital Charge Code	40206013
Hospital Revenue Code	270
Min. Negotiated Rate	$26.46
Max. Negotiated Rate	$60.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.80
Rate for Payer: Aetna Government	$37.80
Rate for Payer: Brighton Health Commercial	$56.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.41
Rate for Payer: Group Health Inc Commercial	$37.80
Rate for Payer: Group Health Inc Medicare	$26.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.80
Rate for Payer: Hamaspik Choice Inc Medicare	$37.80

SHEATH URET ACCESS 13/15FR 28CM

Facility

$1,365.90

Hospital Charge Code	64904869
Hospital Revenue Code	270
Min. Negotiated Rate	$478.06
Max. Negotiated Rate	$1,092.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$751.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$682.95
Rate for Payer: Aetna Government	$682.95
Rate for Payer: Brighton Health Commercial	$1,024.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,092.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$928.81
Rate for Payer: Group Health Inc Commercial	$682.95
Rate for Payer: Group Health Inc Medicare	$478.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$682.95
Rate for Payer: Hamaspik Choice Inc Medicare	$682.95

SHEATH URO

Facility

$343.75

Service Code	HCPCS C1894
Hospital Charge Code	64907159
Hospital Revenue Code	278
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$360.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$189.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.82
Rate for Payer: Aetna Government	$0.82
Rate for Payer: Brighton Health Commercial	$206.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$171.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$197.66
Rate for Payer: EmblemHealth Commercial	$171.88
Rate for Payer: Fidelis Medicare Advantage	$360.94
Rate for Payer: Group Health Inc Commercial	$171.88
Rate for Payer: Group Health Inc Medicare	$120.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.88
Rate for Payer: Hamaspik Choice Inc Medicare	$171.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$223.44

SHEATH URO

Facility

$343.75

Service Code	HCPCS C1894
Hospital Charge Code	64907159
Hospital Revenue Code	278
Min. Negotiated Rate	$171.88
Max. Negotiated Rate	$171.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.88
Rate for Payer: Hamaspik Choice Inc Medicare	$171.88

SHEATH URTHL NAV11/13FR46CM

Facility

$138.00

Service Code	HCPCS C1894
Hospital Charge Code	64906244
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$69.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.00
Rate for Payer: Hamaspik Choice Inc Medicare	$69.00

SHEATH URTHL NAV11/13FR46CM

Facility

$138.00

Service Code	HCPCS C1894
Hospital Charge Code	64906244
Hospital Revenue Code	278
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$144.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$75.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.82
Rate for Payer: Aetna Government	$0.82
Rate for Payer: Brighton Health Commercial	$82.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$69.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$79.35
Rate for Payer: EmblemHealth Commercial	$69.00
Rate for Payer: Fidelis Medicare Advantage	$144.90
Rate for Payer: Group Health Inc Commercial	$69.00
Rate for Payer: Group Health Inc Medicare	$48.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.00
Rate for Payer: Hamaspik Choice Inc Medicare	$69.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$89.70

SHEATH URTH NAV 12/15F 43CM

Facility

$344.87

Service Code	HCPCS C1894
Hospital Charge Code	64906746
Hospital Revenue Code	278
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$362.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$189.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.82
Rate for Payer: Aetna Government	$0.82
Rate for Payer: Brighton Health Commercial	$206.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$172.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$198.30
Rate for Payer: EmblemHealth Commercial	$172.44
Rate for Payer: Fidelis Medicare Advantage	$362.11
Rate for Payer: Group Health Inc Commercial	$172.44
Rate for Payer: Group Health Inc Medicare	$120.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.44
Rate for Payer: Hamaspik Choice Inc Medicare	$172.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$224.17

SHEATH URTH NAV 12/15F 43CM

Facility

$344.87

Service Code	HCPCS C1894
Hospital Charge Code	64906746
Hospital Revenue Code	278
Min. Negotiated Rate	$172.44
Max. Negotiated Rate	$172.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.44
Rate for Payer: Hamaspik Choice Inc Medicare	$172.44

SHEATH WELCH ALLYN EXAM LIGHT

Facility

$165.63

Hospital Charge Code	64902819
Hospital Revenue Code	270
Min. Negotiated Rate	$57.97
Max. Negotiated Rate	$132.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$91.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$82.82
Rate for Payer: Aetna Government	$82.82
Rate for Payer: Brighton Health Commercial	$124.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$132.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.63
Rate for Payer: Group Health Inc Commercial	$82.82
Rate for Payer: Group Health Inc Medicare	$57.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.82
Rate for Payer: Hamaspik Choice Inc Medicare	$82.82

SHEEPSKIN

Facility

$42.88

Hospital Charge Code	40207608
Hospital Revenue Code	270
Min. Negotiated Rate	$15.01
Max. Negotiated Rate	$34.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.44
Rate for Payer: Aetna Government	$21.44
Rate for Payer: Brighton Health Commercial	$32.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.16
Rate for Payer: Group Health Inc Commercial	$21.44
Rate for Payer: Group Health Inc Medicare	$15.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.44
Rate for Payer: Hamaspik Choice Inc Medicare	$21.44

SHEEPSKIN DECUBICARE 30 X 24

Facility

$12.92

Hospital Charge Code	64901072
Hospital Revenue Code	270
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$10.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.46
Rate for Payer: Aetna Government	$6.46
Rate for Payer: Brighton Health Commercial	$9.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.79
Rate for Payer: Group Health Inc Commercial	$6.46
Rate for Payer: Group Health Inc Medicare	$4.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.46
Rate for Payer: Hamaspik Choice Inc Medicare	$6.46

SHEET ARTHRO W/FLUID CTRL POUCH

Facility

$35.01

Hospital Charge Code	64902316
Hospital Revenue Code	270
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$28.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.50
Rate for Payer: Aetna Government	$17.50
Rate for Payer: Brighton Health Commercial	$26.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.81
Rate for Payer: Group Health Inc Commercial	$17.50
Rate for Payer: Group Health Inc Medicare	$12.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50

Know your out-of-pocket cost for care.

All Charges