St. Barnabas Hospital

All Charges

Charge

Type

Price

BREAST IMPLANT,INSPIRA 295CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905682
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREAST IMPLANT,INSPIRA 295CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905682
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 310CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905684
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREAST IMPLANT,INSPIRA 310CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905684
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 330CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905685
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREAST IMPLANT,INSPIRA 330CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905685
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 345CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905686
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREAST IMPLANT,INSPIRA 345CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905686
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 360CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905688
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 360CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905688
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREAST IMPLANT,INSPIRA 375CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905689
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREAST IMPLANT,INSPIRA 375CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905689
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 405CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905690
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 405CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905690
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREAST IMPLANT,INSPIRA 445CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905692
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 445CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905692
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREAST IMPLANT,INSPIRA 485CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905694
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREAST IMPLANT,INSPIRA 485CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905694
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 520CC

Facility OP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905696
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$2,086.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,093.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$993.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,142.81
Rate for Payer: Fidelis Medicare Advantage	$2,086.88
Rate for Payer: Group Health Inc Commercial	$993.75
Rate for Payer: Group Health Inc Medicare	$695.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,291.88

BREAST IMPLANT,INSPIRA 520CC

Facility IP

$1,987.50

Service Code	HCPCS C1789
Hospital Charge Code	64905696
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

BREASTPUMP,SYMPHONY SINGLE SYS

Facility OP

$35.64

Hospital Charge Code	64901594
Hospital Revenue Code	270
Min. Negotiated Rate	$12.47
Max. Negotiated Rate	$28.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.82
Rate for Payer: Aetna Government	$17.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.24
Rate for Payer: Group Health Inc Commercial	$17.82
Rate for Payer: Group Health Inc Medicare	$12.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.82
Rate for Payer: Hamaspik Choice Inc Medicare	$17.82

BREASTPUMP,W/NATURAL EXPRESSION

Facility OP

$45.63

Hospital Charge Code	64901602
Hospital Revenue Code	270
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$36.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.82
Rate for Payer: Aetna Government	$22.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.03
Rate for Payer: Group Health Inc Commercial	$22.82
Rate for Payer: Group Health Inc Medicare	$15.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.82
Rate for Payer: Hamaspik Choice Inc Medicare	$22.82

Breast reduction

Facility OP

$7,541.13

Service Code	CPT 19318
Hospital Revenue Code	360
Min. Negotiated Rate	$1,230.64
Max. Negotiated Rate	$7,541.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7,541.13
Rate for Payer: Aetna Government	$7,541.13
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$7,541.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$7,541.13
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,230.64
Rate for Payer: Fidelis Essential Plan Aliesa	$6,409.96
Rate for Payer: Fidelis Essential Plan QHP	$6,711.61
Rate for Payer: Fidelis Medicare Advantage	$7,541.13
Rate for Payer: Fidelis Qualified Health Plan	$6,711.61
Rate for Payer: Group Health Inc Commercial	$7,541.13
Rate for Payer: Group Health Inc Medicare	$7,541.13
Rate for Payer: Hamaspik Choice Inc Medicare	$7,541.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,367.38
Rate for Payer: Healthfirst Medicare Advantage	$6,409.96
Rate for Payer: Healthfirst QHP	$7,541.13
Rate for Payer: Senior Whole Health Medicare Advantage	$7,541.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,541.13
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6,032.90
Rate for Payer: Wellcare Medicare	$7,164.07

BREAST REDUCTION

Facility OP

$15,862.45

Service Code	HCPCS 19318
Hospital Charge Code	40062300
Hospital Revenue Code	360
Min. Negotiated Rate	$1,230.64
Max. Negotiated Rate	$7,931.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7,541.13
Rate for Payer: Aetna Government	$7,541.13
Rate for Payer: Cash Price	$7,541.13
Rate for Payer: Cash Price	$7,541.13
Rate for Payer: Cash Price	$7,541.13
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$7,541.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$7,541.13
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,230.64
Rate for Payer: Fidelis Essential Plan Aliesa	$6,409.96
Rate for Payer: Fidelis Essential Plan QHP	$6,711.61
Rate for Payer: Fidelis Medicare Advantage	$7,541.13
Rate for Payer: Fidelis Qualified Health Plan	$6,711.61
Rate for Payer: Group Health Inc Commercial	$7,541.13
Rate for Payer: Group Health Inc Medicare	$7,541.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,931.22
Rate for Payer: Hamaspik Choice Inc Medicare	$7,541.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,367.38
Rate for Payer: Healthfirst Medicare Advantage	$6,409.96
Rate for Payer: Healthfirst QHP	$7,541.13
Rate for Payer: Senior Whole Health Medicare Advantage	$7,541.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,541.13
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6,032.90
Rate for Payer: Wellcare Medicare	$7,164.07

BREAST SIZER 76951

Facility OP

$65.00

Service Code	HCPCS C1789
Hospital Charge Code	40201638
Hospital Revenue Code	278
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$402.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.38
Rate for Payer: Fidelis Medicare Advantage	$68.25
Rate for Payer: Group Health Inc Commercial	$32.50
Rate for Payer: Group Health Inc Medicare	$22.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.50
Rate for Payer: Hamaspik Choice Inc Medicare	$32.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$42.25

Price Transparency.

All Charges