St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STR C-SHAPE FRACT PLT 4 HOLE

Facility

$611.42

Service Code	HCPCS C1713
Hospital Charge Code	40203433
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$641.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$336.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$366.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$305.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$351.57
Rate for Payer: EmblemHealth Commercial	$305.71
Rate for Payer: Fidelis Medicare Advantage	$641.99
Rate for Payer: Group Health Inc Commercial	$305.71
Rate for Payer: Group Health Inc Medicare	$214.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$305.71
Rate for Payer: Hamaspik Choice Inc Medicare	$305.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$397.42

STR C-SHAPE FRACT PLT 4 HOLE

Facility

$611.42

Service Code	HCPCS C1713
Hospital Charge Code	40203433
Hospital Revenue Code	278
Min. Negotiated Rate	$305.71
Max. Negotiated Rate	$305.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$305.71
Rate for Payer: Hamaspik Choice Inc Medicare	$305.71

STR DRILL 1.6MM

Facility

$294.48

Hospital Charge Code	40204454
Hospital Revenue Code	272
Min. Negotiated Rate	$103.07
Max. Negotiated Rate	$235.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$161.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$147.24
Rate for Payer: Aetna Government	$147.24
Rate for Payer: Brighton Health Commercial	$220.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$235.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.25
Rate for Payer: Group Health Inc Commercial	$147.24
Rate for Payer: Group Health Inc Medicare	$103.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$147.24
Rate for Payer: Hamaspik Choice Inc Medicare	$147.24

STREPTOMYCIN 1000 MG INJ

Facility

$21.78

Hospital Charge Code	41653860
Hospital Revenue Code	636
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$14.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.89
Rate for Payer: Aetna Government	$10.89
Rate for Payer: Brighton Health Commercial	$13.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.52
Rate for Payer: Group Health Inc Commercial	$10.89
Rate for Payer: Group Health Inc Medicare	$7.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.89
Rate for Payer: Hamaspik Choice Inc Medicare	$10.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.16

STREPTOMYCIN 1000 MG INJ

Facility

$21.78

Hospital Charge Code	41653860
Hospital Revenue Code	636
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$10.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.89
Rate for Payer: Hamaspik Choice Inc Medicare	$10.89

STREPTOMYCIN 1000 MG INJ

Facility

$21.78

Hospital Charge Code	41643860
Hospital Revenue Code	636
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$10.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.89
Rate for Payer: Hamaspik Choice Inc Medicare	$10.89

STREPTOMYCIN 1000 MG INJ

Facility

$21.78

Hospital Charge Code	41643860
Hospital Revenue Code	636
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$14.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.89
Rate for Payer: Aetna Government	$10.89
Rate for Payer: Brighton Health Commercial	$13.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.52
Rate for Payer: Group Health Inc Commercial	$10.89
Rate for Payer: Group Health Inc Medicare	$7.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.89
Rate for Payer: Hamaspik Choice Inc Medicare	$10.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.16

STREPTOMYCIN LEVEL

Facility

$46.60

Service Code	HCPCS 80299
Hospital Charge Code	40609894
Hospital Revenue Code	301
Min. Negotiated Rate	$14.91
Max. Negotiated Rate	$34.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.64
Rate for Payer: Aetna Government	$18.64
Rate for Payer: Brighton Health Commercial	$34.95
Rate for Payer: Cash Price	$18.64
Rate for Payer: Cash Price	$18.64
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$18.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.42
Rate for Payer: Elderplan Medicare Advantage	$18.64
Rate for Payer: EmblemHealth Commercial	$18.64
Rate for Payer: Fidelis Essential Plan Aliesa	$15.84
Rate for Payer: Fidelis Essential Plan QHP	$16.59
Rate for Payer: Fidelis Medicare Advantage	$18.64
Rate for Payer: Fidelis Qualified Health Plan	$16.59
Rate for Payer: Group Health Inc Commercial	$18.64
Rate for Payer: Group Health Inc Medicare	$18.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.30
Rate for Payer: Hamaspik Choice Inc Medicare	$18.64
Rate for Payer: Healthfirst Medicare Advantage	$18.64
Rate for Payer: Healthfirst QHP	$18.64
Rate for Payer: Senior Whole Health Medicare Advantage	$18.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$14.91
Rate for Payer: Wellcare Medicare	$16.78

STREPTOMYCIN LEVEL

Facility

$46.60

Service Code	HCPCS 80299
Hospital Charge Code	40609894
Hospital Revenue Code	301
Rate for Payer: Cash Price	$18.64

STREPTOMYCIN SULFATE 1 G IM SOLR [7508]

Facility

$93.75

Service Code	HCPCS J3000
Hospital Charge Code	39822070602
Hospital Revenue Code	250
Min. Negotiated Rate	$23.06
Max. Negotiated Rate	$75.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.55
Rate for Payer: Aetna Government	$34.55
Rate for Payer: Brighton Health Commercial	$70.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.75
Rate for Payer: Group Health Inc Commercial	$46.88
Rate for Payer: Group Health Inc Medicare	$32.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$46.88
Rate for Payer: Hamaspik Choice Inc Medicare	$46.88
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$23.06
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$24.45
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$24.45
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$24.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$60.94

STRESS BREAKER

Facility

$284.00

Service Code	HCPCS D6940
Hospital Charge Code	42301590
Hospital Revenue Code	361
Min. Negotiated Rate	$87.46
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$87.46
Rate for Payer: Aetna Government	$87.46
Rate for Payer: Brighton Health Commercial	$213.00
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: Group Health Inc Commercial	$142.00
Rate for Payer: Group Health Inc Medicare	$99.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.00
Rate for Payer: Hamaspik Choice Inc Medicare	$142.00

STRESS TEST

Facility

$101.25

Hospital Charge Code	30301324
Hospital Revenue Code	510
Min. Negotiated Rate	$50.62
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.62
Rate for Payer: Aetna Government	$50.62
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.62
Rate for Payer: Hamaspik Choice Inc Medicare	$50.62

STRESS TEST (FETAL CONTRACTION)

Facility

$502.93

Service Code	HCPCS 59020 TC
Hospital Charge Code	40250200
Hospital Revenue Code	720
Rate for Payer: Cash Price	$230.44

STRESS TEST (FETAL CONTRACTION)

Facility

$502.93

Service Code	HCPCS 59020 TC
Hospital Charge Code	40250200
Hospital Revenue Code	720
Min. Negotiated Rate	$176.03
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$251.46
Rate for Payer: Aetna Government	$251.46
Rate for Payer: Brighton Health Commercial	$377.20
Rate for Payer: Cash Price	$230.44
Rate for Payer: Cash Price	$230.44
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: Group Health Inc Commercial	$251.46
Rate for Payer: Group Health Inc Medicare	$176.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.46
Rate for Payer: Hamaspik Choice Inc Medicare	$251.46

STR HYBRID 9 HOLE PLATE

Facility

$585.00

Service Code	HCPCS C1713
Hospital Charge Code	40204452
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$614.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$321.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$351.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$292.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$336.38
Rate for Payer: EmblemHealth Commercial	$292.50
Rate for Payer: Fidelis Medicare Advantage	$614.25
Rate for Payer: Group Health Inc Commercial	$292.50
Rate for Payer: Group Health Inc Medicare	$204.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$292.50
Rate for Payer: Hamaspik Choice Inc Medicare	$292.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$380.25

STR HYBRID 9 HOLE PLATE

Facility

$585.00

Service Code	HCPCS C1713
Hospital Charge Code	40204452
Hospital Revenue Code	278
Min. Negotiated Rate	$292.50
Max. Negotiated Rate	$292.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$292.50
Rate for Payer: Hamaspik Choice Inc Medicare	$292.50

STR HYBRID 9 HOLE PLT

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	40204441
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00

STR HYBRID 9 HOLE PLT

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	40204441
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$693.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$363.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$396.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$330.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$379.50
Rate for Payer: EmblemHealth Commercial	$330.00
Rate for Payer: Fidelis Medicare Advantage	$693.00
Rate for Payer: Group Health Inc Commercial	$330.00
Rate for Payer: Group Health Inc Medicare	$231.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$429.00

STRIP,CLOSURE,SKIN,REINFO,1/2X4

Facility

$2.13

Hospital Charge Code	64901485
Hospital Revenue Code	270
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.06
Rate for Payer: Aetna Government	$1.06
Rate for Payer: Brighton Health Commercial	$1.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.45
Rate for Payer: Group Health Inc Commercial	$1.06
Rate for Payer: Group Health Inc Medicare	$0.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1.06

STRIP,INTEGRATOR,STEAMPLUS,4

Facility

$0.21

Hospital Charge Code	64905241
Hospital Revenue Code	270
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.11
Rate for Payer: Aetna Government	$0.11
Rate for Payer: Brighton Health Commercial	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11
Rate for Payer: Hamaspik Choice Inc Medicare	$0.11

STRIP MONITOR DUAL

Facility

$17.00

Hospital Charge Code	64902219
Hospital Revenue Code	270
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$13.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.50
Rate for Payer: Aetna Government	$8.50
Rate for Payer: Brighton Health Commercial	$12.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.56
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

STRIP, MULTISTIX 10 SG REAGENT

Facility

$0.79

Hospital Charge Code	64901870
Hospital Revenue Code	270
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.40
Rate for Payer: Aetna Government	$0.40
Rate for Payer: Brighton Health Commercial	$0.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.54
Rate for Payer: Group Health Inc Commercial	$0.40
Rate for Payer: Group Health Inc Medicare	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.40
Rate for Payer: Hamaspik Choice Inc Medicare	$0.40

STRIPPER AX-IT PLUS 5GAL PAILS

Facility

$102.63

Hospital Charge Code	64902799
Hospital Revenue Code	270
Min. Negotiated Rate	$35.92
Max. Negotiated Rate	$82.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.32
Rate for Payer: Aetna Government	$51.32
Rate for Payer: Brighton Health Commercial	$76.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$82.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.79
Rate for Payer: Group Health Inc Commercial	$51.32
Rate for Payer: Group Health Inc Medicare	$35.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.32
Rate for Payer: Hamaspik Choice Inc Medicare	$51.32

STRIP POSTEROLATERAL 50X20X7MM

Facility

$13,375.00

Hospital Charge Code	64906098
Hospital Revenue Code	270
Min. Negotiated Rate	$4,681.25
Max. Negotiated Rate	$10,700.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,356.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,687.50
Rate for Payer: Aetna Government	$6,687.50
Rate for Payer: Brighton Health Commercial	$10,031.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,095.00
Rate for Payer: Group Health Inc Commercial	$6,687.50
Rate for Payer: Group Health Inc Medicare	$4,681.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,687.50

STRIP POSTEROLATERAL 50X20X7MM

Facility

$10,700.00

Hospital Charge Code	40005127
Hospital Revenue Code	272
Min. Negotiated Rate	$3,745.00
Max. Negotiated Rate	$8,560.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,885.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,350.00
Rate for Payer: Aetna Government	$5,350.00
Rate for Payer: Brighton Health Commercial	$8,025.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,560.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,276.00
Rate for Payer: Group Health Inc Commercial	$5,350.00
Rate for Payer: Group Health Inc Medicare	$3,745.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,350.00

Know your out-of-pocket cost for care.

All Charges