St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SOLUTION,DURAPREP,APPLICATOR,26ML

Facility

$9.44

Hospital Charge Code	64905074
Hospital Revenue Code	270
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$7.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.72
Rate for Payer: Aetna Government	$4.72
Rate for Payer: Brighton Health Commercial	$7.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.42
Rate for Payer: Group Health Inc Commercial	$4.72
Rate for Payer: Group Health Inc Medicare	$3.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.72
Rate for Payer: Hamaspik Choice Inc Medicare	$4.72

SOLUTION,GLYCINE 1.5,IRRIGA,300

Facility

$16.42

Hospital Charge Code	64902537
Hospital Revenue Code	270
Min. Negotiated Rate	$5.75
Max. Negotiated Rate	$13.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Brighton Health Commercial	$12.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.17
Rate for Payer: Group Health Inc Commercial	$8.21
Rate for Payer: Group Health Inc Medicare	$5.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.21
Rate for Payer: Hamaspik Choice Inc Medicare	$8.21

SOLUTION GYLCINE IRRIG 1.5L BTL

Facility

$53.15

Hospital Charge Code	64904092
Hospital Revenue Code	270
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$42.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.58
Rate for Payer: Aetna Government	$26.58
Rate for Payer: Brighton Health Commercial	$39.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.14
Rate for Payer: Group Health Inc Commercial	$26.58
Rate for Payer: Group Health Inc Medicare	$18.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.58
Rate for Payer: Hamaspik Choice Inc Medicare	$26.58

SOLUTION,PREP,POVIDONE IOD

Facility

$2.50

Hospital Charge Code	64901161
Hospital Revenue Code	270
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$2.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.25
Rate for Payer: Aetna Government	$1.25
Rate for Payer: Brighton Health Commercial	$1.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.70
Rate for Payer: Group Health Inc Commercial	$1.25
Rate for Payer: Group Health Inc Medicare	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25

SOLUTION QC-QC5 LVL1 RED

Facility

$10.35

Hospital Charge Code	64902714
Hospital Revenue Code	270
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$8.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.18
Rate for Payer: Aetna Government	$5.18
Rate for Payer: Brighton Health Commercial	$7.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.04
Rate for Payer: Group Health Inc Commercial	$5.18
Rate for Payer: Group Health Inc Medicare	$3.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.18
Rate for Payer: Hamaspik Choice Inc Medicare	$5.18

SOLUTION,RINGER'S,INJ,LACT

Facility

$3.42

Hospital Charge Code	64901386
Hospital Revenue Code	270
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$2.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.71
Rate for Payer: Aetna Government	$1.71
Rate for Payer: Brighton Health Commercial	$2.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.33
Rate for Payer: Group Health Inc Commercial	$1.71
Rate for Payer: Group Health Inc Medicare	$1.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.71
Rate for Payer: Hamaspik Choice Inc Medicare	$1.71

SOLUTION,RINGERS,LACTATED,INJ

Facility

$0.14

Service Code	HCPCS S5010
Hospital Charge Code	64901383
Hospital Revenue Code	258
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$5.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.09

SOLUTION,RINGERS,LACT,INJ,10

Facility

$3.17

Hospital Charge Code	64901402
Hospital Revenue Code	270
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$2.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.58
Rate for Payer: Aetna Government	$1.58
Rate for Payer: Brighton Health Commercial	$2.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.16
Rate for Payer: Group Health Inc Commercial	$1.58
Rate for Payer: Group Health Inc Medicare	$1.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1.58

SOLUTION,RINGERS LACT,INJ,500

Facility

$2.90

Service Code	HCPCS S5010
Hospital Charge Code	64901904
Hospital Revenue Code	258
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$5.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Brighton Health Commercial	$2.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.97
Rate for Payer: Group Health Inc Commercial	$1.45
Rate for Payer: Group Health Inc Medicare	$1.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.45
Rate for Payer: Hamaspik Choice Inc Medicare	$1.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.88

SOLUTION SET 1.8M (70 )

Facility

$3.55

Hospital Charge Code	40509818
Hospital Revenue Code	260
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$2.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.78
Rate for Payer: Aetna Government	$1.78
Rate for Payer: Brighton Health Commercial	$2.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.41
Rate for Payer: Group Health Inc Commercial	$1.78
Rate for Payer: Group Health Inc Medicare	$1.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.78
Rate for Payer: Hamaspik Choice Inc Medicare	$1.78

SOLUTION,SODIUM CHL,0.45,1000M

Facility

$3.46

Hospital Charge Code	64901415
Hospital Revenue Code	270
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$2.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.73
Rate for Payer: Aetna Government	$1.73
Rate for Payer: Brighton Health Commercial	$2.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.35
Rate for Payer: Group Health Inc Commercial	$1.73
Rate for Payer: Group Health Inc Medicare	$1.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.73
Rate for Payer: Hamaspik Choice Inc Medicare	$1.73

SOLUTION,SODIUM CHL,0.9,1000ML

Facility

$2.99

Hospital Charge Code	64901379
Hospital Revenue Code	270
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.03
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

SOLUTION,SODIUM CHL,0.9,250ML

Facility

$2.60

Hospital Charge Code	64901372
Hospital Revenue Code	270
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$2.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.30
Rate for Payer: Aetna Government	$1.30
Rate for Payer: Brighton Health Commercial	$1.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.77
Rate for Payer: Group Health Inc Commercial	$1.30
Rate for Payer: Group Health Inc Medicare	$0.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1.30

SOLUTION,SODIUM CHL,0.9,IRG,10

Facility

$3.56

Hospital Charge Code	64901406
Hospital Revenue Code	270
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$2.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.78
Rate for Payer: Aetna Government	$1.78
Rate for Payer: Brighton Health Commercial	$2.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.42
Rate for Payer: Group Health Inc Commercial	$1.78
Rate for Payer: Group Health Inc Medicare	$1.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.78
Rate for Payer: Hamaspik Choice Inc Medicare	$1.78

SOLUTION,SODIUM CHL,0.9,IRG,50

Facility

$3.30

Hospital Charge Code	64901969
Hospital Revenue Code	270
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$2.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.65
Rate for Payer: Aetna Government	$1.65
Rate for Payer: Brighton Health Commercial	$2.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.24
Rate for Payer: Group Health Inc Commercial	$1.65
Rate for Payer: Group Health Inc Medicare	$1.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.65
Rate for Payer: Hamaspik Choice Inc Medicare	$1.65

SOLUTION,SODIUM CHL,500ML .9

Facility

$2.76

Hospital Charge Code	64901375
Hospital Revenue Code	270
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$2.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.38
Rate for Payer: Aetna Government	$1.38
Rate for Payer: Brighton Health Commercial	$2.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.88
Rate for Payer: Group Health Inc Commercial	$1.38
Rate for Payer: Group Health Inc Medicare	$0.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1.38

SOLUTION,SODIUM CHL,INJ,0.9

Facility

$23.59

Hospital Charge Code	64902279
Hospital Revenue Code	270
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$18.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.80
Rate for Payer: Aetna Government	$11.80
Rate for Payer: Brighton Health Commercial	$17.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.04
Rate for Payer: Group Health Inc Commercial	$11.80
Rate for Payer: Group Health Inc Medicare	$8.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.80
Rate for Payer: Hamaspik Choice Inc Medicare	$11.80

SOLUTION,SODIUM CHLO,0.9,100ML

Facility

$1.47

Hospital Charge Code	64902280
Hospital Revenue Code	270
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$1.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.74
Rate for Payer: Aetna Government	$0.74
Rate for Payer: Brighton Health Commercial	$1.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.00
Rate for Payer: Group Health Inc Commercial	$0.74
Rate for Payer: Group Health Inc Medicare	$0.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.74
Rate for Payer: Hamaspik Choice Inc Medicare	$0.74

SOLUTION SUCROSE SWEET EASE

Facility

$1.31

Hospital Charge Code	64903391
Hospital Revenue Code	270
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$1.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.66
Rate for Payer: Aetna Government	$0.66
Rate for Payer: Brighton Health Commercial	$0.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.89
Rate for Payer: Group Health Inc Commercial	$0.66
Rate for Payer: Group Health Inc Medicare	$0.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.66
Rate for Payer: Hamaspik Choice Inc Medicare	$0.66

SOLUTION TRANSFER SET

Facility

$25.52

Hospital Charge Code	42905210
Hospital Revenue Code	801
Min. Negotiated Rate	$8.93
Max. Negotiated Rate	$20.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.76
Rate for Payer: Aetna Government	$12.76
Rate for Payer: Brighton Health Commercial	$19.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.35
Rate for Payer: Group Health Inc Commercial	$12.76
Rate for Payer: Group Health Inc Medicare	$8.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.76
Rate for Payer: Hamaspik Choice Inc Medicare	$12.76

SOLYX SLING SYSTEM

Facility

$4,520.25

Hospital Charge Code	64907131
Hospital Revenue Code	279
Min. Negotiated Rate	$1,582.09
Max. Negotiated Rate	$3,616.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,486.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,260.12
Rate for Payer: Aetna Government	$2,260.12
Rate for Payer: Brighton Health Commercial	$3,390.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,616.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,073.77
Rate for Payer: Group Health Inc Commercial	$2,260.12
Rate for Payer: Group Health Inc Medicare	$1,582.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,260.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,260.12

SOMATOMEDIN

Facility

$53.15

Service Code	HCPCS 84305
Hospital Charge Code	30305721
Hospital Revenue Code	301
Min. Negotiated Rate	$17.01
Max. Negotiated Rate	$39.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.26
Rate for Payer: Aetna Government	$21.26
Rate for Payer: Brighton Health Commercial	$39.86
Rate for Payer: Cash Price	$21.26
Rate for Payer: Cash Price	$21.26
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$21.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.60
Rate for Payer: Elderplan Medicare Advantage	$21.26
Rate for Payer: EmblemHealth Commercial	$21.26
Rate for Payer: Fidelis Essential Plan Aliesa	$18.07
Rate for Payer: Fidelis Essential Plan QHP	$18.92
Rate for Payer: Fidelis Medicare Advantage	$21.26
Rate for Payer: Fidelis Qualified Health Plan	$18.92
Rate for Payer: Group Health Inc Commercial	$21.26
Rate for Payer: Group Health Inc Medicare	$21.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.58
Rate for Payer: Hamaspik Choice Inc Medicare	$21.26
Rate for Payer: Healthfirst Medicare Advantage	$21.26
Rate for Payer: Healthfirst QHP	$21.26
Rate for Payer: Senior Whole Health Medicare Advantage	$21.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.26
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17.01
Rate for Payer: Wellcare Medicare	$19.13

SOMATOMEDIN

Facility

$53.15

Service Code	HCPCS 84305
Hospital Charge Code	30305721
Hospital Revenue Code	301
Rate for Payer: Cash Price	$21.26

SONIC CTRL SERRATED AGG KNIFE

Facility

$1,750.20

Hospital Charge Code	64906004
Hospital Revenue Code	270
Min. Negotiated Rate	$612.57
Max. Negotiated Rate	$1,400.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.10
Rate for Payer: Aetna Government	$875.10
Rate for Payer: Brighton Health Commercial	$1,312.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,400.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.14
Rate for Payer: Group Health Inc Commercial	$875.10
Rate for Payer: Group Health Inc Medicare	$612.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.10
Rate for Payer: Hamaspik Choice Inc Medicare	$875.10

SONO CHECK

Facility

$13.99

Hospital Charge Code	64903598
Hospital Revenue Code	270
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$11.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.00
Rate for Payer: Aetna Government	$7.00
Rate for Payer: Brighton Health Commercial	$10.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.51
Rate for Payer: Group Health Inc Commercial	$7.00
Rate for Payer: Group Health Inc Medicare	$4.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.00
Rate for Payer: Hamaspik Choice Inc Medicare	$7.00

Know your out-of-pocket cost for care.

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