St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TRAY IMPRESSION LOWER LARGE

Facility

$1.84

Hospital Charge Code	64903659
Hospital Revenue Code	270
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$1.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.92
Rate for Payer: Aetna Government	$0.92
Rate for Payer: Brighton Health Commercial	$1.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.25
Rate for Payer: Group Health Inc Commercial	$0.92
Rate for Payer: Group Health Inc Medicare	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.92
Rate for Payer: Hamaspik Choice Inc Medicare	$0.92

TRAY IMPRESSION LOWER MEDIUM

Facility

$1.40

Hospital Charge Code	64903663
Hospital Revenue Code	270
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$1.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.70
Rate for Payer: Aetna Government	$0.70
Rate for Payer: Brighton Health Commercial	$1.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.95
Rate for Payer: Group Health Inc Commercial	$0.70
Rate for Payer: Group Health Inc Medicare	$0.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.70
Rate for Payer: Hamaspik Choice Inc Medicare	$0.70

TRAY IMPRESSION UPPER LARGE

Facility

$1.84

Hospital Charge Code	64903661
Hospital Revenue Code	270
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$1.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.92
Rate for Payer: Aetna Government	$0.92
Rate for Payer: Brighton Health Commercial	$1.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.25
Rate for Payer: Group Health Inc Commercial	$0.92
Rate for Payer: Group Health Inc Medicare	$0.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.92
Rate for Payer: Hamaspik Choice Inc Medicare	$0.92

TRAY,INSERTION,UMBIL,3.5FR

Facility

$143.12

Hospital Charge Code	64902473
Hospital Revenue Code	270
Min. Negotiated Rate	$50.09
Max. Negotiated Rate	$114.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$78.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$71.56
Rate for Payer: Aetna Government	$71.56
Rate for Payer: Brighton Health Commercial	$107.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.32
Rate for Payer: Group Health Inc Commercial	$71.56
Rate for Payer: Group Health Inc Medicare	$50.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.56
Rate for Payer: Hamaspik Choice Inc Medicare	$71.56

TRAY, IRRIGATION, BULB-SYRINGE&F

Facility

$2.53

Hospital Charge Code	64901688
Hospital Revenue Code	270
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$2.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.26
Rate for Payer: Aetna Government	$1.26
Rate for Payer: Brighton Health Commercial	$1.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Group Health Inc Commercial	$1.26
Rate for Payer: Group Health Inc Medicare	$0.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.26
Rate for Payer: Hamaspik Choice Inc Medicare	$1.26

TRAY,LUMBAR PUNC,INFANT,21X2.5,S

Facility

$17.20

Hospital Charge Code	64901948
Hospital Revenue Code	270
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$13.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.60
Rate for Payer: Aetna Government	$8.60
Rate for Payer: Brighton Health Commercial	$12.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.70
Rate for Payer: Group Health Inc Commercial	$8.60
Rate for Payer: Group Health Inc Medicare	$6.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.60
Rate for Payer: Hamaspik Choice Inc Medicare	$8.60

TRAY,LUMBAR PUNCTURE,20X3.5

Facility

$20.63

Hospital Charge Code	64901740
Hospital Revenue Code	270
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$16.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.32
Rate for Payer: Aetna Government	$10.32
Rate for Payer: Brighton Health Commercial	$15.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.03
Rate for Payer: Group Health Inc Commercial	$10.32
Rate for Payer: Group Health Inc Medicare	$7.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.32
Rate for Payer: Hamaspik Choice Inc Medicare	$10.32

TRAY MAMMOTOME CONFIRM MCTRAY

Facility

$11.14

Hospital Charge Code	41301570
Hospital Revenue Code	270
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$8.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.57
Rate for Payer: Aetna Government	$5.57
Rate for Payer: Brighton Health Commercial	$8.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.58
Rate for Payer: Group Health Inc Commercial	$5.57
Rate for Payer: Group Health Inc Medicare	$3.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.57
Rate for Payer: Hamaspik Choice Inc Medicare	$5.57

TRAY,METER,16 FR,LATEX FREE

Facility

$24.58

Hospital Charge Code	64901625
Hospital Revenue Code	270
Min. Negotiated Rate	$8.60
Max. Negotiated Rate	$19.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.29
Rate for Payer: Aetna Government	$12.29
Rate for Payer: Brighton Health Commercial	$18.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.71
Rate for Payer: Group Health Inc Commercial	$12.29
Rate for Payer: Group Health Inc Medicare	$8.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.29
Rate for Payer: Hamaspik Choice Inc Medicare	$12.29

TRAY,METER,18 FR LATEX FREE

Facility

$24.58

Hospital Charge Code	64901629
Hospital Revenue Code	270
Min. Negotiated Rate	$8.60
Max. Negotiated Rate	$19.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.29
Rate for Payer: Aetna Government	$12.29
Rate for Payer: Brighton Health Commercial	$18.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.71
Rate for Payer: Group Health Inc Commercial	$12.29
Rate for Payer: Group Health Inc Medicare	$8.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.29
Rate for Payer: Hamaspik Choice Inc Medicare	$12.29

TRAY,METER,200ML,CATHETER,ALL S

Facility

$27.80

Hospital Charge Code	64901997
Hospital Revenue Code	279
Min. Negotiated Rate	$9.73
Max. Negotiated Rate	$22.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.90
Rate for Payer: Aetna Government	$13.90
Rate for Payer: Brighton Health Commercial	$20.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.90
Rate for Payer: Group Health Inc Commercial	$13.90
Rate for Payer: Group Health Inc Medicare	$9.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.90
Rate for Payer: Hamaspik Choice Inc Medicare	$13.90

TRAY REUSABLE STERILIZATION

Facility

$750.00

Hospital Charge Code	64907104
Hospital Revenue Code	270
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$412.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$375.00
Rate for Payer: Aetna Government	$375.00
Rate for Payer: Brighton Health Commercial	$562.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$510.00
Rate for Payer: Group Health Inc Commercial	$375.00
Rate for Payer: Group Health Inc Medicare	$262.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$375.00
Rate for Payer: Hamaspik Choice Inc Medicare	$375.00

TRAY SINGLE LUMEN 2FR 28CM STYLET

Facility

$55.43

Hospital Charge Code	64902443
Hospital Revenue Code	270
Min. Negotiated Rate	$19.40
Max. Negotiated Rate	$44.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.72
Rate for Payer: Aetna Government	$27.72
Rate for Payer: Brighton Health Commercial	$41.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.69
Rate for Payer: Group Health Inc Commercial	$27.72
Rate for Payer: Group Health Inc Medicare	$19.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.72
Rate for Payer: Hamaspik Choice Inc Medicare	$27.72

TRAY SKIN PREP DRY W/BASIN

Facility

$7.89

Hospital Charge Code	64901930
Hospital Revenue Code	270
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$6.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.94
Rate for Payer: Aetna Government	$3.94
Rate for Payer: Brighton Health Commercial	$5.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.37
Rate for Payer: Group Health Inc Commercial	$3.94
Rate for Payer: Group Health Inc Medicare	$2.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.94
Rate for Payer: Hamaspik Choice Inc Medicare	$3.94

TRAY SPINAL ANES W/TETRACAINE

Facility

$31.26

Hospital Charge Code	64901872
Hospital Revenue Code	270
Min. Negotiated Rate	$10.94
Max. Negotiated Rate	$25.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.63
Rate for Payer: Aetna Government	$15.63
Rate for Payer: Brighton Health Commercial	$23.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.26
Rate for Payer: Group Health Inc Commercial	$15.63
Rate for Payer: Group Health Inc Medicare	$10.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.63
Rate for Payer: Hamaspik Choice Inc Medicare	$15.63

TRAY SPINAL/EPIDURAL COMBINED

Facility

$115.00

Hospital Charge Code	64902773
Hospital Revenue Code	270
Min. Negotiated Rate	$40.25
Max. Negotiated Rate	$92.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.50
Rate for Payer: Aetna Government	$57.50
Rate for Payer: Brighton Health Commercial	$86.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$92.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.20
Rate for Payer: Group Health Inc Commercial	$57.50
Rate for Payer: Group Health Inc Medicare	$40.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.50
Rate for Payer: Hamaspik Choice Inc Medicare	$57.50

TRAY SUBCLAVIAN INSERTION

Facility

$202.62

Hospital Charge Code	40209481
Hospital Revenue Code	270
Min. Negotiated Rate	$70.92
Max. Negotiated Rate	$162.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$111.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$101.31
Rate for Payer: Aetna Government	$101.31
Rate for Payer: Brighton Health Commercial	$151.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$162.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$137.78
Rate for Payer: Group Health Inc Commercial	$101.31
Rate for Payer: Group Health Inc Medicare	$70.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$101.31
Rate for Payer: Hamaspik Choice Inc Medicare	$101.31

TRAY, SUTURE REMOVAL

Facility

$285.00

Hospital Charge Code	64906020
Hospital Revenue Code	270
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$228.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$142.50
Rate for Payer: Aetna Government	$142.50
Rate for Payer: Brighton Health Commercial	$213.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$228.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$193.80
Rate for Payer: Group Health Inc Commercial	$142.50
Rate for Payer: Group Health Inc Medicare	$99.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50

TRAY,THORACENTESIS,DRAINAGE

Facility

$179.83

Hospital Charge Code	64901183
Hospital Revenue Code	270
Min. Negotiated Rate	$62.94
Max. Negotiated Rate	$143.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$89.92
Rate for Payer: Aetna Government	$89.92
Rate for Payer: Brighton Health Commercial	$134.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$122.28
Rate for Payer: Group Health Inc Commercial	$89.92
Rate for Payer: Group Health Inc Medicare	$62.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.92
Rate for Payer: Hamaspik Choice Inc Medicare	$89.92

TRAY TIB MED

Facility

$5,535.00

Hospital Charge Code	64907422
Hospital Revenue Code	279
Min. Negotiated Rate	$1,937.25
Max. Negotiated Rate	$4,428.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,044.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,767.50
Rate for Payer: Aetna Government	$2,767.50
Rate for Payer: Brighton Health Commercial	$4,151.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,428.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,763.80
Rate for Payer: Group Health Inc Commercial	$2,767.50
Rate for Payer: Group Health Inc Medicare	$1,937.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,767.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,767.50

TRAY TRACHEOSTOMY CARE W/2 4X4'S

Facility

$3.69

Hospital Charge Code	64901685
Hospital Revenue Code	270
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$2.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.84
Rate for Payer: Aetna Government	$1.84
Rate for Payer: Brighton Health Commercial	$2.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.51
Rate for Payer: Group Health Inc Commercial	$1.84
Rate for Payer: Group Health Inc Medicare	$1.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.84
Rate for Payer: Hamaspik Choice Inc Medicare	$1.84

TRAY URETHRAL CATH 14FR 75000

Facility

$5.99

Hospital Charge Code	64901662
Hospital Revenue Code	279
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Brighton Health Commercial	$4.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.07
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00

TRAY URINE METER 18FR TEMP SENSOR

Facility

$39.54

Hospital Charge Code	64903276
Hospital Revenue Code	270
Min. Negotiated Rate	$13.84
Max. Negotiated Rate	$31.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.77
Rate for Payer: Aetna Government	$19.77
Rate for Payer: Brighton Health Commercial	$29.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$31.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.89
Rate for Payer: Group Health Inc Commercial	$19.77
Rate for Payer: Group Health Inc Medicare	$13.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.77
Rate for Payer: Hamaspik Choice Inc Medicare	$19.77

TRAY WAYNE PNEUMOTHORAX A

Facility

$470.67

Hospital Charge Code	64901529
Hospital Revenue Code	270
Min. Negotiated Rate	$164.73
Max. Negotiated Rate	$376.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$235.34
Rate for Payer: Aetna Government	$235.34
Rate for Payer: Brighton Health Commercial	$353.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$376.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$320.06
Rate for Payer: Group Health Inc Commercial	$235.34
Rate for Payer: Group Health Inc Medicare	$164.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.34
Rate for Payer: Hamaspik Choice Inc Medicare	$235.34

TRAZODONE 100 MG TAB

Facility

$0.13

Hospital Charge Code	41641070
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.09
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.08

Know your out-of-pocket cost for care.

All Charges