St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STAPLER,INTERNAL,LINEAR,PROXIMAT

Facility

$230.38

Hospital Charge Code	64902930
Hospital Revenue Code	270
Min. Negotiated Rate	$80.63
Max. Negotiated Rate	$184.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$115.19
Rate for Payer: Aetna Government	$115.19
Rate for Payer: Brighton Health Commercial	$172.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$184.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.66
Rate for Payer: Group Health Inc Commercial	$115.19
Rate for Payer: Group Health Inc Medicare	$80.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.19
Rate for Payer: Hamaspik Choice Inc Medicare	$115.19

STAPLER INTERNAL RELOADBL 60MML

Facility

$995.25

Hospital Charge Code	64905173
Hospital Revenue Code	270
Min. Negotiated Rate	$348.34
Max. Negotiated Rate	$796.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$547.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$497.62
Rate for Payer: Aetna Government	$497.62
Rate for Payer: Brighton Health Commercial	$746.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$796.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$676.77
Rate for Payer: Group Health Inc Commercial	$497.62
Rate for Payer: Group Health Inc Medicare	$348.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$497.62
Rate for Payer: Hamaspik Choice Inc Medicare	$497.62

STAPLER LINEAR A

Facility

$227.10

Hospital Charge Code	64902925
Hospital Revenue Code	270
Min. Negotiated Rate	$79.48
Max. Negotiated Rate	$181.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$124.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$113.55
Rate for Payer: Aetna Government	$113.55
Rate for Payer: Brighton Health Commercial	$170.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$181.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$154.43
Rate for Payer: Group Health Inc Commercial	$113.55
Rate for Payer: Group Health Inc Medicare	$79.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.55
Rate for Payer: Hamaspik Choice Inc Medicare	$113.55

STAPLER LINEAR C

Facility

$106.94

Hospital Charge Code	64902927
Hospital Revenue Code	270
Min. Negotiated Rate	$37.43
Max. Negotiated Rate	$85.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$53.47
Rate for Payer: Aetna Government	$53.47
Rate for Payer: Brighton Health Commercial	$80.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$85.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$72.72
Rate for Payer: Group Health Inc Commercial	$53.47
Rate for Payer: Group Health Inc Medicare	$37.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.47
Rate for Payer: Hamaspik Choice Inc Medicare	$53.47

STAPLER LINEAR D

Facility

$106.94

Hospital Charge Code	64902928
Hospital Revenue Code	270
Min. Negotiated Rate	$37.43
Max. Negotiated Rate	$85.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$53.47
Rate for Payer: Aetna Government	$53.47
Rate for Payer: Brighton Health Commercial	$80.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$85.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$72.72
Rate for Payer: Group Health Inc Commercial	$53.47
Rate for Payer: Group Health Inc Medicare	$37.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.47
Rate for Payer: Hamaspik Choice Inc Medicare	$53.47

STAPLER,LINEAR,PROXIMATE,90MM

Facility

$253.63

Hospital Charge Code	64905141
Hospital Revenue Code	270
Min. Negotiated Rate	$88.77
Max. Negotiated Rate	$202.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$139.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$126.82
Rate for Payer: Aetna Government	$126.82
Rate for Payer: Brighton Health Commercial	$190.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$202.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.47
Rate for Payer: Group Health Inc Commercial	$126.82
Rate for Payer: Group Health Inc Medicare	$88.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.82
Rate for Payer: Hamaspik Choice Inc Medicare	$126.82

STAPLER LINEAR TX60G

Facility

$230.38

Hospital Charge Code	64902712
Hospital Revenue Code	270
Min. Negotiated Rate	$80.63
Max. Negotiated Rate	$184.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$115.19
Rate for Payer: Aetna Government	$115.19
Rate for Payer: Brighton Health Commercial	$172.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$184.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.66
Rate for Payer: Group Health Inc Commercial	$115.19
Rate for Payer: Group Health Inc Medicare	$80.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.19
Rate for Payer: Hamaspik Choice Inc Medicare	$115.19

STAPLER SKIN APPOSE

Facility

$13.83

Hospital Charge Code	64907098
Hospital Revenue Code	270
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$11.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.92
Rate for Payer: Aetna Government	$6.92
Rate for Payer: Brighton Health Commercial	$10.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.40
Rate for Payer: Group Health Inc Commercial	$6.92
Rate for Payer: Group Health Inc Medicare	$4.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.92
Rate for Payer: Hamaspik Choice Inc Medicare	$6.92

STAPLER SKIN FX HD SIGNET 35W

Facility

$28.13

Hospital Charge Code	64901533
Hospital Revenue Code	270
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$22.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.06
Rate for Payer: Aetna Government	$14.06
Rate for Payer: Brighton Health Commercial	$21.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.13
Rate for Payer: Group Health Inc Commercial	$14.06
Rate for Payer: Group Health Inc Medicare	$9.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.06
Rate for Payer: Hamaspik Choice Inc Medicare	$14.06

STAPLER SKIN MULTIFIRE PREM

Facility

$21.58

Hospital Charge Code	64907099
Hospital Revenue Code	270
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$17.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.79
Rate for Payer: Aetna Government	$10.79
Rate for Payer: Brighton Health Commercial	$16.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.67
Rate for Payer: Group Health Inc Commercial	$10.79
Rate for Payer: Group Health Inc Medicare	$7.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.79
Rate for Payer: Hamaspik Choice Inc Medicare	$10.79

STAPLER SKIN MULTIFIRE VERSATACK

Facility

$1,596.96

Hospital Charge Code	40205116
Hospital Revenue Code	270
Min. Negotiated Rate	$558.94
Max. Negotiated Rate	$1,277.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$878.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$798.48
Rate for Payer: Aetna Government	$798.48
Rate for Payer: Brighton Health Commercial	$1,197.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,277.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,085.93
Rate for Payer: Group Health Inc Commercial	$798.48
Rate for Payer: Group Health Inc Medicare	$558.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$798.48
Rate for Payer: Hamaspik Choice Inc Medicare	$798.48

STAPLER,SKIN,PROXI PLUS MD,WIDE

Facility

$12.50

Hospital Charge Code	64902923
Hospital Revenue Code	270
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$10.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.25
Rate for Payer: Aetna Government	$6.25
Rate for Payer: Brighton Health Commercial	$9.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.50
Rate for Payer: Group Health Inc Commercial	$6.25
Rate for Payer: Group Health Inc Medicare	$4.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.25
Rate for Payer: Hamaspik Choice Inc Medicare	$6.25

STAPLER TA60-4.8 SU RELOADABLE

Facility

$190.00

Hospital Charge Code	40206042
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

STAPLE SMALL 11 X 8MM

Facility

$812.50

Hospital Charge Code	64901840
Hospital Revenue Code	279
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Brighton Health Commercial	$609.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

STAPLE SMALL 13 X 10MM

Facility

$812.50

Hospital Charge Code	64901841
Hospital Revenue Code	279
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Brighton Health Commercial	$609.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

STAPLE SMALL 15 X 12MM 1.5MM WIRE

Facility

$775.00

Hospital Charge Code	64904706
Hospital Revenue Code	270
Min. Negotiated Rate	$271.25
Max. Negotiated Rate	$620.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$426.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$387.50
Rate for Payer: Aetna Government	$387.50
Rate for Payer: Brighton Health Commercial	$581.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$620.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$527.00
Rate for Payer: Group Health Inc Commercial	$387.50
Rate for Payer: Group Health Inc Medicare	$271.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$387.50
Rate for Payer: Hamaspik Choice Inc Medicare	$387.50

STAPLE SMALL 7 X 5MM

Facility

$812.50

Hospital Charge Code	64901836
Hospital Revenue Code	279
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Brighton Health Commercial	$609.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

STAPLE SMALL 9 X 7MM

Facility

$812.50

Hospital Charge Code	64901838
Hospital Revenue Code	279
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Brighton Health Commercial	$609.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

STAPLES X-SMALL 7 X 5MM

Facility

$812.50

Hospital Charge Code	64902127
Hospital Revenue Code	279
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Brighton Health Commercial	$609.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

STAPLE TRI RELOD 60MM MD/THCK

Facility

$933.94

Hospital Charge Code	64906558
Hospital Revenue Code	279
Min. Negotiated Rate	$326.88
Max. Negotiated Rate	$747.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$513.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$466.97
Rate for Payer: Aetna Government	$466.97
Rate for Payer: Brighton Health Commercial	$700.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$747.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$635.08
Rate for Payer: Group Health Inc Commercial	$466.97
Rate for Payer: Group Health Inc Medicare	$326.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$466.97
Rate for Payer: Hamaspik Choice Inc Medicare	$466.97

STAPLE TRI RELOD 60MM XT/THCK-AXT

Facility

$1,546.40

Hospital Charge Code	64906702
Hospital Revenue Code	279
Min. Negotiated Rate	$541.24
Max. Negotiated Rate	$1,237.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$850.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$773.20
Rate for Payer: Aetna Government	$773.20
Rate for Payer: Brighton Health Commercial	$1,159.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,237.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,051.55
Rate for Payer: Group Health Inc Commercial	$773.20
Rate for Payer: Group Health Inc Medicare	$541.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$773.20
Rate for Payer: Hamaspik Choice Inc Medicare	$773.20

STAPLE X-SMALL 9 X 7MM

Facility

$812.50

Hospital Charge Code	64902129
Hospital Revenue Code	279
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Brighton Health Commercial	$609.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

STARGRAFT DBM PUTTY 10CC

Facility

$4,450.00

Service Code	HCPCS C1713
Hospital Charge Code	64904680
Hospital Revenue Code	278
Min. Negotiated Rate	$2,225.00
Max. Negotiated Rate	$2,225.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,225.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,225.00

STARGRAFT DBM PUTTY 10CC

Facility

$4,450.00

Service Code	HCPCS C1713
Hospital Charge Code	64904680
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,672.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,447.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,670.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,225.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,558.75
Rate for Payer: EmblemHealth Commercial	$2,225.00
Rate for Payer: Fidelis Medicare Advantage	$4,672.50
Rate for Payer: Group Health Inc Commercial	$2,225.00
Rate for Payer: Group Health Inc Medicare	$1,557.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,225.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,225.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,892.50

STARGRAFT DEM 10CC PUTTY

Facility

$4,325.00

Service Code	HCPCS C1713
Hospital Charge Code	64904124
Hospital Revenue Code	278
Min. Negotiated Rate	$2,162.50
Max. Negotiated Rate	$2,162.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,162.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,162.50

Know your out-of-pocket cost for care.

All Charges