St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TANGNTL BX SKIN SINGLE LES

Facility

$529.23

Service Code	HCPCS 11102
Hospital Charge Code	42501050
Hospital Revenue Code	510
Rate for Payer: Cash Price	$231.52

TANGNTL BX SKIN SINGLE LES

Facility

$529.23

Service Code	HCPCS 11102
Hospital Charge Code	30307913
Hospital Revenue Code	510
Min. Negotiated Rate	$185.22
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$231.52
Rate for Payer: Aetna Government	$231.52
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$231.52
Rate for Payer: Cash Price	$231.52
Rate for Payer: Cash Price	$231.52
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$231.52
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	$231.52
Rate for Payer: Fidelis Essential Plan Aliesa	$196.79
Rate for Payer: Fidelis Essential Plan QHP	$206.05
Rate for Payer: Fidelis Medicare Advantage	$231.52
Rate for Payer: Fidelis Qualified Health Plan	$206.05
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	$264.62
Rate for Payer: Hamaspik Choice Inc Medicare	$231.52
Rate for Payer: Healthfirst Medicare Advantage	$196.79
Rate for Payer: Healthfirst QHP	$231.52
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$231.52
Rate for Payer: Senior Whole Health Medicare Advantage	$231.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$231.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$185.22
Rate for Payer: Wellcare Medicare	$219.94

TANGNTL BX SKIN SINGLE LES

Facility

$529.23

Service Code	HCPCS 11102
Hospital Charge Code	42501050
Hospital Revenue Code	510
Min. Negotiated Rate	$185.22
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$231.52
Rate for Payer: Aetna Government	$231.52
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$231.52
Rate for Payer: Cash Price	$231.52
Rate for Payer: Cash Price	$231.52
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$231.52
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	$231.52
Rate for Payer: Fidelis Essential Plan Aliesa	$196.79
Rate for Payer: Fidelis Essential Plan QHP	$206.05
Rate for Payer: Fidelis Medicare Advantage	$231.52
Rate for Payer: Fidelis Qualified Health Plan	$206.05
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	$264.62
Rate for Payer: Hamaspik Choice Inc Medicare	$231.52
Rate for Payer: Healthfirst Medicare Advantage	$196.79
Rate for Payer: Healthfirst QHP	$231.52
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$231.52
Rate for Payer: Senior Whole Health Medicare Advantage	$231.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$231.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$185.22
Rate for Payer: Wellcare Medicare	$219.94

TANGNTL BX SKIN SINGLE LES

Facility

$529.23

Service Code	HCPCS 11102
Hospital Charge Code	66543700
Hospital Revenue Code	361
Rate for Payer: Cash Price	$231.52

TAN NAIL 8.5X36CM

Facility

$3,720.00

Service Code	HCPCS C1713
Hospital Charge Code	40202304
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,906.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,046.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,232.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,860.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,139.00
Rate for Payer: EmblemHealth Commercial	$1,860.00
Rate for Payer: Fidelis Medicare Advantage	$3,906.00
Rate for Payer: Group Health Inc Commercial	$1,860.00
Rate for Payer: Group Health Inc Medicare	$1,302.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,860.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,860.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,418.00

TAN NAIL 8.5X36CM

Facility

$3,720.00

Service Code	HCPCS C1713
Hospital Charge Code	40202304
Hospital Revenue Code	278
Min. Negotiated Rate	$1,860.00
Max. Negotiated Rate	$1,860.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,860.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,860.00

T & A, OVER AGE 12

Facility

$7,933.18

Service Code	HCPCS 42821
Hospital Charge Code	40109208
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$5,949.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,880.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,723.23
Rate for Payer: Aetna Government	$3,723.23
Rate for Payer: Brighton Health Commercial	$5,949.88
Rate for Payer: Cash Price	$3,723.23
Rate for Payer: Cash Price	$3,723.23
Rate for Payer: Cash Price	$3,723.23
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,723.23
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	$3,723.23
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,164.75
Rate for Payer: Fidelis Essential Plan QHP	$3,313.67
Rate for Payer: Fidelis Medicare Advantage	$3,723.23
Rate for Payer: Fidelis Qualified Health Plan	$3,313.67
Rate for Payer: Group Health Inc Commercial	$3,723.23
Rate for Payer: Group Health Inc Medicare	$3,723.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,966.59
Rate for Payer: Hamaspik Choice Inc Medicare	$3,723.23
Rate for Payer: Healthfirst Medicare Advantage	$3,164.75
Rate for Payer: Healthfirst QHP	$3,723.23
Rate for Payer: Senior Whole Health Medicare Advantage	$3,723.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,723.23
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,978.58
Rate for Payer: Wellcare Medicare	$3,537.07

T & A, OVER AGE 12

Facility

$7,933.18

Service Code	HCPCS 42821
Hospital Charge Code	40109208
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,723.23

TAP

Facility

$748.00

Service Code	HCPCS C1713
Hospital Charge Code	40200315
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$785.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$411.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$448.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$374.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$430.10
Rate for Payer: EmblemHealth Commercial	$374.00
Rate for Payer: Fidelis Medicare Advantage	$785.40
Rate for Payer: Group Health Inc Commercial	$374.00
Rate for Payer: Group Health Inc Medicare	$261.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$374.00
Rate for Payer: Hamaspik Choice Inc Medicare	$374.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$486.20

TAP

Facility

$748.00

Service Code	HCPCS C1713
Hospital Charge Code	40200315
Hospital Revenue Code	278
Min. Negotiated Rate	$374.00
Max. Negotiated Rate	$374.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$374.00
Rate for Payer: Hamaspik Choice Inc Medicare	$374.00

TAP 3.0MM

Facility

$900.00

Hospital Charge Code	40205528
Hospital Revenue Code	270
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$720.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$495.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$450.00
Rate for Payer: Aetna Government	$450.00
Rate for Payer: Brighton Health Commercial	$675.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$720.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$612.00
Rate for Payer: Group Health Inc Commercial	$450.00
Rate for Payer: Group Health Inc Medicare	$315.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00

TAP BONE CANNULATED 5MM DIA 30

Facility

$1,415.00

Service Code	HCPCS C1713
Hospital Charge Code	64904941
Hospital Revenue Code	278
Min. Negotiated Rate	$707.50
Max. Negotiated Rate	$707.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$707.50
Rate for Payer: Hamaspik Choice Inc Medicare	$707.50

TAP BONE CANNULATED 5MM DIA 30

Facility

$1,415.00

Service Code	HCPCS C1713
Hospital Charge Code	64904941
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,485.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$778.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$849.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$707.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$813.62
Rate for Payer: EmblemHealth Commercial	$707.50
Rate for Payer: Fidelis Medicare Advantage	$1,485.75
Rate for Payer: Group Health Inc Commercial	$707.50
Rate for Payer: Group Health Inc Medicare	$495.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$707.50
Rate for Payer: Hamaspik Choice Inc Medicare	$707.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$919.75

TAP CANNLTD SERATO 5.5

Facility

$3,324.48

Service Code	HCPCS C1713
Hospital Charge Code	64906870
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,490.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,828.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,994.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,662.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,911.58
Rate for Payer: EmblemHealth Commercial	$1,662.24
Rate for Payer: Fidelis Medicare Advantage	$3,490.70
Rate for Payer: Group Health Inc Commercial	$1,662.24
Rate for Payer: Group Health Inc Medicare	$1,163.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,662.24
Rate for Payer: Hamaspik Choice Inc Medicare	$1,662.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,160.91

TAP CANNLTD SERATO 5.5

Facility

$3,324.48

Service Code	HCPCS C1713
Hospital Charge Code	64906870
Hospital Revenue Code	278
Min. Negotiated Rate	$1,662.24
Max. Negotiated Rate	$1,662.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,662.24
Rate for Payer: Hamaspik Choice Inc Medicare	$1,662.24

TAP CANNULATED 6.0

Facility

$3,292.50

Service Code	HCPCS C1713
Hospital Charge Code	64907514
Hospital Revenue Code	278
Min. Negotiated Rate	$1,646.25
Max. Negotiated Rate	$1,646.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,646.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,646.25

TAP CANNULATED 6.0

Facility

$3,292.50

Service Code	HCPCS C1713
Hospital Charge Code	64907514
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,457.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,810.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,975.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,646.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,893.19
Rate for Payer: EmblemHealth Commercial	$1,646.25
Rate for Payer: Fidelis Medicare Advantage	$3,457.12
Rate for Payer: Group Health Inc Commercial	$1,646.25
Rate for Payer: Group Health Inc Medicare	$1,152.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,646.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,646.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,140.12

TAPE,DELTA-LITE PL,CST MX 3X4

Facility

$6.46

Hospital Charge Code	64902201
Hospital Revenue Code	270
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$5.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.23
Rate for Payer: Aetna Government	$3.23
Rate for Payer: Brighton Health Commercial	$4.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.39
Rate for Payer: Group Health Inc Commercial	$3.23
Rate for Payer: Group Health Inc Medicare	$2.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.23
Rate for Payer: Hamaspik Choice Inc Medicare	$3.23

TAPE,DELTA-LITE PL CST MX 4X4

Facility

$8.38

Hospital Charge Code	64902198
Hospital Revenue Code	270
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$6.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.19
Rate for Payer: Aetna Government	$4.19
Rate for Payer: Brighton Health Commercial	$6.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.70
Rate for Payer: Group Health Inc Commercial	$4.19
Rate for Payer: Group Health Inc Medicare	$2.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.19
Rate for Payer: Hamaspik Choice Inc Medicare	$4.19

TAPE ELASTIC STRETCHED ELASTIKON

Facility

$13.05

Hospital Charge Code	64901717
Hospital Revenue Code	270
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$10.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.52
Rate for Payer: Aetna Government	$6.52
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.87
Rate for Payer: Group Health Inc Commercial	$6.52
Rate for Payer: Group Health Inc Medicare	$4.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$6.52

TAPE GLOW 'N TELL

Facility

$141.13

Hospital Charge Code	64904190
Hospital Revenue Code	270
Min. Negotiated Rate	$49.40
Max. Negotiated Rate	$112.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.56
Rate for Payer: Aetna Government	$70.56
Rate for Payer: Brighton Health Commercial	$105.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.97
Rate for Payer: Group Health Inc Commercial	$70.56
Rate for Payer: Group Health Inc Medicare	$49.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.56
Rate for Payer: Hamaspik Choice Inc Medicare	$70.56

TAPE GLOW' N TELL

Facility

$100.00

Hospital Charge Code	40205982
Hospital Revenue Code	270
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$80.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.00
Rate for Payer: Aetna Government	$50.00
Rate for Payer: Brighton Health Commercial	$75.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.00
Rate for Payer: Group Health Inc Commercial	$50.00
Rate for Payer: Group Health Inc Medicare	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.00
Rate for Payer: Hamaspik Choice Inc Medicare	$50.00

TAPE,HY

Facility

$3.75

Hospital Charge Code	64903187
Hospital Revenue Code	270
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$3.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.88
Rate for Payer: Aetna Government	$1.88
Rate for Payer: Brighton Health Commercial	$2.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.55
Rate for Payer: Group Health Inc Commercial	$1.88
Rate for Payer: Group Health Inc Medicare	$1.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.88
Rate for Payer: Hamaspik Choice Inc Medicare	$1.88

TAPE HYPO ALLERG ET II W/H

Facility

$15.06

Hospital Charge Code	64902069
Hospital Revenue Code	270
Min. Negotiated Rate	$5.27
Max. Negotiated Rate	$12.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.53
Rate for Payer: Aetna Government	$7.53
Rate for Payer: Brighton Health Commercial	$11.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.24
Rate for Payer: Group Health Inc Commercial	$7.53
Rate for Payer: Group Health Inc Medicare	$5.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.53
Rate for Payer: Hamaspik Choice Inc Medicare	$7.53

TAPE MEASURING DISPOSABLE

Facility

$0.05

Hospital Charge Code	64901869
Hospital Revenue Code	270
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

Know your out-of-pocket cost for care.

All Charges