St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TAPENTADOL 100 MG TABLET

Facility

$5.00

Hospital Charge Code	41646090
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Brighton Health Commercial	$3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

TAPENTADOL 50 MG TABLET

Facility

$5.00

Hospital Charge Code	41656090
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Brighton Health Commercial	$3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

TAPENTADOL 75 MG TABLET

Facility

$4.80

Hospital Charge Code	41656088
Hospital Revenue Code	250
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$3.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.40
Rate for Payer: Aetna Government	$2.40
Rate for Payer: Brighton Health Commercial	$3.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.26
Rate for Payer: Group Health Inc Commercial	$2.40
Rate for Payer: Group Health Inc Medicare	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.40
Rate for Payer: Hamaspik Choice Inc Medicare	$2.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.12

TAPENTADOL 75MG TABLET

Facility

$4.80

Hospital Charge Code	41646088
Hospital Revenue Code	250
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$3.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.40
Rate for Payer: Aetna Government	$2.40
Rate for Payer: Brighton Health Commercial	$3.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.26
Rate for Payer: Group Health Inc Commercial	$2.40
Rate for Payer: Group Health Inc Medicare	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.40
Rate for Payer: Hamaspik Choice Inc Medicare	$2.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.12

TAPENTADOL HCL 100 MG PO TABS [98255]

Facility

$19.78

Service Code	NDC 24510010010
Hospital Charge Code	24510010010
Hospital Revenue Code	250
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$15.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.89
Rate for Payer: Aetna Government	$9.89
Rate for Payer: Brighton Health Commercial	$14.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.45
Rate for Payer: Group Health Inc Commercial	$9.89
Rate for Payer: Group Health Inc Medicare	$6.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.89
Rate for Payer: Hamaspik Choice Inc Medicare	$9.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.86

TAPENTADOL HCL 50 MG PO TABS [98253]

Facility

$12.70

Service Code	NDC 24510005010
Hospital Charge Code	24510005010
Hospital Revenue Code	250
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$10.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.35
Rate for Payer: Aetna Government	$6.35
Rate for Payer: Brighton Health Commercial	$9.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.64
Rate for Payer: Group Health Inc Commercial	$6.35
Rate for Payer: Group Health Inc Medicare	$4.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.26

TAPENTADOL HCL 75 MG PO TABS [98254]

Facility

$14.84

Service Code	NDC 24510007510
Hospital Charge Code	24510007510
Hospital Revenue Code	250
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$11.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.42
Rate for Payer: Aetna Government	$7.42
Rate for Payer: Brighton Health Commercial	$11.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.09
Rate for Payer: Group Health Inc Commercial	$7.42
Rate for Payer: Group Health Inc Medicare	$5.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.42
Rate for Payer: Hamaspik Choice Inc Medicare	$7.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.65

TAPE PAPER MICROPORE 1X10YD

Facility

$0.84

Hospital Charge Code	40209453
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Brighton Health Commercial	$0.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42

TAPE,PAPER,SURG,MICR,1X10Y

Facility

$0.67

Hospital Charge Code	64901715
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.34
Rate for Payer: Aetna Government	$0.34
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.46
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34

TAPE,PAPER,SURG,MICR,2X10Y

Facility

$1.34

Hospital Charge Code	64901712
Hospital Revenue Code	270
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$1.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.67
Rate for Payer: Aetna Government	$0.67
Rate for Payer: Brighton Health Commercial	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.91
Rate for Payer: Group Health Inc Commercial	$0.67
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67

TAPE,PAPER,SURG,MICR,3X10Y

Facility

$2.04

Hospital Charge Code	64901709
Hospital Revenue Code	270
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$1.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.02
Rate for Payer: Aetna Government	$1.02
Rate for Payer: Brighton Health Commercial	$1.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.39
Rate for Payer: Group Health Inc Commercial	$1.02
Rate for Payer: Group Health Inc Medicare	$0.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1.02

TAPE PLASTIC 1/2 TRANSPORE

Facility

$0.65

Hospital Charge Code	64901937
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.33
Rate for Payer: Aetna Government	$0.33
Rate for Payer: Brighton Health Commercial	$0.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.44
Rate for Payer: Group Health Inc Commercial	$0.33
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33
Rate for Payer: Hamaspik Choice Inc Medicare	$0.33

TAPER STEM PLUG

Facility

$1,692.00

Hospital Charge Code	40200044
Hospital Revenue Code	279
Min. Negotiated Rate	$592.20
Max. Negotiated Rate	$1,353.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$930.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$846.00
Rate for Payer: Aetna Government	$846.00
Rate for Payer: Brighton Health Commercial	$1,269.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,353.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,150.56
Rate for Payer: Group Health Inc Commercial	$846.00
Rate for Payer: Group Health Inc Medicare	$592.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$846.00
Rate for Payer: Hamaspik Choice Inc Medicare	$846.00

TAPE SILK 1X10YD HYPOALL15831

Facility

$1.06

Hospital Charge Code	40209454
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.53
Rate for Payer: Aetna Government	$0.53
Rate for Payer: Brighton Health Commercial	$0.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.72
Rate for Payer: Group Health Inc Commercial	$0.53
Rate for Payer: Group Health Inc Medicare	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.53
Rate for Payer: Hamaspik Choice Inc Medicare	$0.53

TAPE SILK HYPOALLERGENIC

Facility

$1.16

Hospital Charge Code	64901232
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.58
Rate for Payer: Aetna Government	$0.58
Rate for Payer: Brighton Health Commercial	$0.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.79
Rate for Payer: Group Health Inc Commercial	$0.58
Rate for Payer: Group Health Inc Medicare	$0.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.58
Rate for Payer: Hamaspik Choice Inc Medicare	$0.58

TAPE SLK HYPOALLERGENIC

Facility

$3.66

Hospital Charge Code	64901032
Hospital Revenue Code	270
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$2.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.83
Rate for Payer: Aetna Government	$1.83
Rate for Payer: Brighton Health Commercial	$2.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.49
Rate for Payer: Group Health Inc Commercial	$1.83
Rate for Payer: Group Health Inc Medicare	$1.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.83
Rate for Payer: Hamaspik Choice Inc Medicare	$1.83

TAPE,SURG,TRANSPORE

Facility

$1.26

Hospital Charge Code	64902051
Hospital Revenue Code	270
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$1.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.63
Rate for Payer: Aetna Government	$0.63
Rate for Payer: Brighton Health Commercial	$0.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.86
Rate for Payer: Group Health Inc Commercial	$0.63
Rate for Payer: Group Health Inc Medicare	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.63
Rate for Payer: Hamaspik Choice Inc Medicare	$0.63

TAPE SUTURE FIBERWIRE 1.3MM

Facility

$5.82

Hospital Charge Code	64906795
Hospital Revenue Code	270
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$4.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.91
Rate for Payer: Aetna Government	$2.91
Rate for Payer: Brighton Health Commercial	$4.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.96
Rate for Payer: Group Health Inc Commercial	$2.91
Rate for Payer: Group Health Inc Medicare	$2.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.91
Rate for Payer: Hamaspik Choice Inc Medicare	$2.91

TAPE TRANSPORE PLASTIC

Facility

$15.18

Hospital Charge Code	64905577
Hospital Revenue Code	270
Min. Negotiated Rate	$5.31
Max. Negotiated Rate	$12.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.59
Rate for Payer: Aetna Government	$7.59
Rate for Payer: Brighton Health Commercial	$11.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.32
Rate for Payer: Group Health Inc Commercial	$7.59
Rate for Payer: Group Health Inc Medicare	$5.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.59
Rate for Payer: Hamaspik Choice Inc Medicare	$7.59

TAPE UMBILICAL

Facility

$4.78

Hospital Charge Code	64907101
Hospital Revenue Code	270
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$3.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.39
Rate for Payer: Aetna Government	$2.39
Rate for Payer: Brighton Health Commercial	$3.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.25
Rate for Payer: Group Health Inc Commercial	$2.39
Rate for Payer: Group Health Inc Medicare	$1.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.39
Rate for Payer: Hamaspik Choice Inc Medicare	$2.39

TAPE UMBILICAL COTTON

Facility

$2.85

Hospital Charge Code	64902580
Hospital Revenue Code	270
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$2.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.42
Rate for Payer: Aetna Government	$1.42
Rate for Payer: Brighton Health Commercial	$2.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.94
Rate for Payer: Group Health Inc Commercial	$1.42
Rate for Payer: Group Health Inc Medicare	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.42
Rate for Payer: Hamaspik Choice Inc Medicare	$1.42

TAP FOR 4.0MM NCB DEEP TH

Facility

$393.06

Service Code	HCPCS C1713
Hospital Charge Code	40006766
Hospital Revenue Code	278
Min. Negotiated Rate	$196.53
Max. Negotiated Rate	$196.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.53
Rate for Payer: Hamaspik Choice Inc Medicare	$196.53

TAP FOR 4.0MM NCB DEEP TH

Facility

$393.06

Service Code	HCPCS C1713
Hospital Charge Code	40006766
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$412.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$235.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$196.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.01
Rate for Payer: EmblemHealth Commercial	$196.53
Rate for Payer: Fidelis Medicare Advantage	$412.71
Rate for Payer: Group Health Inc Commercial	$196.53
Rate for Payer: Group Health Inc Medicare	$137.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.53
Rate for Payer: Hamaspik Choice Inc Medicare	$196.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$255.49

TAP SERRATO

Facility

$3,292.50

Service Code	HCPCS C1713
Hospital Charge Code	64907498
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

TAP SERRATO

Facility

$3,292.50

Service Code	HCPCS C1713
Hospital Charge Code	64907498
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

Know your out-of-pocket cost for care.

All Charges