St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TROCAR BALLOON&INFLATION BULB

Facility

$531.08

Service Code	HCPCS C1725
Hospital Charge Code	40207000
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$557.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$292.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$318.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$265.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$305.37
Rate for Payer: EmblemHealth Commercial	$265.54
Rate for Payer: Fidelis Medicare Advantage	$557.63
Rate for Payer: Group Health Inc Commercial	$265.54
Rate for Payer: Group Health Inc Medicare	$185.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$265.54
Rate for Payer: Hamaspik Choice Inc Medicare	$265.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$345.20

TROCAR BLADELESS 5MM W

Facility

$40.70

Hospital Charge Code	64907081
Hospital Revenue Code	270
Min. Negotiated Rate	$14.24
Max. Negotiated Rate	$32.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.35
Rate for Payer: Aetna Government	$20.35
Rate for Payer: Brighton Health Commercial	$30.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.68
Rate for Payer: Group Health Inc Commercial	$20.35
Rate for Payer: Group Health Inc Medicare	$14.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.35
Rate for Payer: Hamaspik Choice Inc Medicare	$20.35

TROCAR,BLADELESS,OB,OPT,12/100MM

Facility

$114.20

Hospital Charge Code	64904369
Hospital Revenue Code	270
Min. Negotiated Rate	$39.97
Max. Negotiated Rate	$91.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.10
Rate for Payer: Aetna Government	$57.10
Rate for Payer: Brighton Health Commercial	$85.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$91.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.66
Rate for Payer: Group Health Inc Commercial	$57.10
Rate for Payer: Group Health Inc Medicare	$39.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.10
Rate for Payer: Hamaspik Choice Inc Medicare	$57.10

TROCAR BLADELESS W/OPT 5X100MM

Facility

$57.63

Hospital Charge Code	64906043
Hospital Revenue Code	270
Min. Negotiated Rate	$20.17
Max. Negotiated Rate	$46.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.82
Rate for Payer: Aetna Government	$28.82
Rate for Payer: Brighton Health Commercial	$43.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.19
Rate for Payer: Group Health Inc Commercial	$28.82
Rate for Payer: Group Health Inc Medicare	$20.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.82
Rate for Payer: Hamaspik Choice Inc Medicare	$28.82

TROCAR BLADELESS W/OPT 5X75MM

Facility

$375.00

Hospital Charge Code	64906044
Hospital Revenue Code	270
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$300.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$187.50
Rate for Payer: Aetna Government	$187.50
Rate for Payer: Brighton Health Commercial	$281.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$255.00
Rate for Payer: Group Health Inc Commercial	$187.50
Rate for Payer: Group Health Inc Medicare	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.50
Rate for Payer: Hamaspik Choice Inc Medicare	$187.50

TROCAR BLADELESS W/ST 12X100MM

Facility

$83.60

Hospital Charge Code	64906046
Hospital Revenue Code	270
Min. Negotiated Rate	$29.26
Max. Negotiated Rate	$66.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.80
Rate for Payer: Aetna Government	$41.80
Rate for Payer: Brighton Health Commercial	$62.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.85
Rate for Payer: Group Health Inc Commercial	$41.80
Rate for Payer: Group Health Inc Medicare	$29.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.80
Rate for Payer: Hamaspik Choice Inc Medicare	$41.80

TROCAR BLADELESS W/STAB-REPROCES

Facility

$426.90

Hospital Charge Code	64905430
Hospital Revenue Code	270
Min. Negotiated Rate	$149.42
Max. Negotiated Rate	$341.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$234.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$213.45
Rate for Payer: Aetna Government	$213.45
Rate for Payer: Brighton Health Commercial	$320.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$341.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$290.29
Rate for Payer: Group Health Inc Commercial	$213.45
Rate for Payer: Group Health Inc Medicare	$149.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$213.45
Rate for Payer: Hamaspik Choice Inc Medicare	$213.45

TROCAR BLADELESS XCEL W/STABILITY

Facility

$12.48

Hospital Charge Code	64905811
Hospital Revenue Code	270
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$9.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.24
Rate for Payer: Aetna Government	$6.24
Rate for Payer: Brighton Health Commercial	$9.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.49
Rate for Payer: Group Health Inc Commercial	$6.24
Rate for Payer: Group Health Inc Medicare	$4.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.24
Rate for Payer: Hamaspik Choice Inc Medicare	$6.24

TROCAR BLPRT PLS 5-12MM W/FMGRP

Facility

$124.00

Hospital Charge Code	40206037
Hospital Revenue Code	270
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$99.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.00
Rate for Payer: Aetna Government	$62.00
Rate for Payer: Brighton Health Commercial	$93.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.32
Rate for Payer: Group Health Inc Commercial	$62.00
Rate for Payer: Group Health Inc Medicare	$43.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.00
Rate for Payer: Hamaspik Choice Inc Medicare	$62.00

TROCAR BLUNT TIP SYRINGE

Facility

$180.00

Hospital Charge Code	64904167
Hospital Revenue Code	270
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$144.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$99.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$90.00
Rate for Payer: Aetna Government	$90.00
Rate for Payer: Brighton Health Commercial	$135.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$144.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$122.40
Rate for Payer: Group Health Inc Commercial	$90.00
Rate for Payer: Group Health Inc Medicare	$63.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.00
Rate for Payer: Hamaspik Choice Inc Medicare	$90.00

TROCAR BLUNT TP XCEL 12X100 REPR

Facility

$83.60

Hospital Charge Code	64905433
Hospital Revenue Code	270
Min. Negotiated Rate	$29.26
Max. Negotiated Rate	$66.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.80
Rate for Payer: Aetna Government	$41.80
Rate for Payer: Brighton Health Commercial	$62.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.85
Rate for Payer: Group Health Inc Commercial	$41.80
Rate for Payer: Group Health Inc Medicare	$29.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.80
Rate for Payer: Hamaspik Choice Inc Medicare	$41.80

TROCAR DRILL PIN 3.2 75MM

Facility

$847.50

Hospital Charge Code	64906072
Hospital Revenue Code	270
Min. Negotiated Rate	$296.62
Max. Negotiated Rate	$678.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$466.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$423.75
Rate for Payer: Aetna Government	$423.75
Rate for Payer: Brighton Health Commercial	$635.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$678.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$576.30
Rate for Payer: Group Health Inc Commercial	$423.75
Rate for Payer: Group Health Inc Medicare	$296.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.75
Rate for Payer: Hamaspik Choice Inc Medicare	$423.75

TROCAR ENDOPATH XCEL 12MM BLDLS

Facility

$132.45

Hospital Charge Code	64904627
Hospital Revenue Code	270
Min. Negotiated Rate	$46.36
Max. Negotiated Rate	$105.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$72.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$66.22
Rate for Payer: Aetna Government	$66.22
Rate for Payer: Brighton Health Commercial	$99.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$105.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$90.07
Rate for Payer: Group Health Inc Commercial	$66.22
Rate for Payer: Group Health Inc Medicare	$46.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.22
Rate for Payer: Hamaspik Choice Inc Medicare	$66.22

TROCAR ENDOPATH XCEL 5M BLDLS

Facility

$304.22

Hospital Charge Code	40206056
Hospital Revenue Code	270
Min. Negotiated Rate	$106.48
Max. Negotiated Rate	$243.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$167.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$152.11
Rate for Payer: Aetna Government	$152.11
Rate for Payer: Brighton Health Commercial	$228.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$243.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$206.87
Rate for Payer: Group Health Inc Commercial	$152.11
Rate for Payer: Group Health Inc Medicare	$106.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$152.11
Rate for Payer: Hamaspik Choice Inc Medicare	$152.11

TROCAR,ENDO XCEL,BLDLS,11MM,STRL

Facility

$110.81

Hospital Charge Code	64904365
Hospital Revenue Code	270
Min. Negotiated Rate	$38.78
Max. Negotiated Rate	$88.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$60.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$55.40
Rate for Payer: Aetna Government	$55.40
Rate for Payer: Brighton Health Commercial	$83.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$88.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$75.35
Rate for Payer: Group Health Inc Commercial	$55.40
Rate for Payer: Group Health Inc Medicare	$38.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.40
Rate for Payer: Hamaspik Choice Inc Medicare	$55.40

TROCAR TIP DILA BLADS

Facility

$300.00

Hospital Charge Code	40206049
Hospital Revenue Code	270
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$150.00
Rate for Payer: Aetna Government	$150.00
Rate for Payer: Brighton Health Commercial	$225.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$204.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

TROCAR VERSA1 BLNT

Facility

$35.60

Hospital Charge Code	64907102
Hospital Revenue Code	270
Min. Negotiated Rate	$12.46
Max. Negotiated Rate	$28.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.80
Rate for Payer: Aetna Government	$17.80
Rate for Payer: Brighton Health Commercial	$26.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.21
Rate for Payer: Group Health Inc Commercial	$17.80
Rate for Payer: Group Health Inc Medicare	$12.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.80
Rate for Payer: Hamaspik Choice Inc Medicare	$17.80

TROCAR VERSPRT BLDS

Facility

$65.10

Hospital Charge Code	64907103
Hospital Revenue Code	270
Min. Negotiated Rate	$22.78
Max. Negotiated Rate	$52.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.55
Rate for Payer: Aetna Government	$32.55
Rate for Payer: Brighton Health Commercial	$48.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.27
Rate for Payer: Group Health Inc Commercial	$32.55
Rate for Payer: Group Health Inc Medicare	$22.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.55
Rate for Payer: Hamaspik Choice Inc Medicare	$32.55

TROCAR,XCEL,BLESS,ST SLV,5/150MM

Facility

$100.09

Hospital Charge Code	64904624
Hospital Revenue Code	270
Min. Negotiated Rate	$35.03
Max. Negotiated Rate	$80.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.04
Rate for Payer: Aetna Government	$50.04
Rate for Payer: Brighton Health Commercial	$75.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.06
Rate for Payer: Group Health Inc Commercial	$50.04
Rate for Payer: Group Health Inc Medicare	$35.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.04
Rate for Payer: Hamaspik Choice Inc Medicare	$50.04

TROCAR, XCEL, BL, STA SLV 5/100MM

Facility

$86.28

Hospital Charge Code	64904361
Hospital Revenue Code	270
Min. Negotiated Rate	$30.20
Max. Negotiated Rate	$69.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.14
Rate for Payer: Aetna Government	$43.14
Rate for Payer: Brighton Health Commercial	$64.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$69.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.67
Rate for Payer: Group Health Inc Commercial	$43.14
Rate for Payer: Group Health Inc Medicare	$30.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.14
Rate for Payer: Hamaspik Choice Inc Medicare	$43.14

TROCAR,XCEL,BLUNT TIP,12MMX100MM

Facility

$147.01

Hospital Charge Code	64904373
Hospital Revenue Code	270
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$117.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.50
Rate for Payer: Aetna Government	$73.50
Rate for Payer: Brighton Health Commercial	$110.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$117.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.97
Rate for Payer: Group Health Inc Commercial	$73.50
Rate for Payer: Group Health Inc Medicare	$51.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.50
Rate for Payer: Hamaspik Choice Inc Medicare	$73.50

TROCAR XCEL BLUNT TIP 12X100MM

Facility

$73.03

Hospital Charge Code	64906045
Hospital Revenue Code	270
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$58.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$40.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$36.52
Rate for Payer: Aetna Government	$36.52
Rate for Payer: Brighton Health Commercial	$54.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.66
Rate for Payer: Group Health Inc Commercial	$36.52
Rate for Payer: Group Health Inc Medicare	$25.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.52
Rate for Payer: Hamaspik Choice Inc Medicare	$36.52

TROCAR,XCEL W OPTIVIEW,BLADELESS

Facility

$112.50

Hospital Charge Code	64905225
Hospital Revenue Code	270
Min. Negotiated Rate	$39.38
Max. Negotiated Rate	$90.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.25
Rate for Payer: Aetna Government	$56.25
Rate for Payer: Brighton Health Commercial	$84.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.50
Rate for Payer: Group Health Inc Commercial	$56.25
Rate for Payer: Group Health Inc Medicare	$39.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.25
Rate for Payer: Hamaspik Choice Inc Medicare	$56.25

TROCATH TRAY

Facility

$57.06

Hospital Charge Code	40505905
Hospital Revenue Code	260
Min. Negotiated Rate	$19.97
Max. Negotiated Rate	$45.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.53
Rate for Payer: Aetna Government	$28.53
Rate for Payer: Brighton Health Commercial	$42.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.80
Rate for Payer: Group Health Inc Commercial	$28.53
Rate for Payer: Group Health Inc Medicare	$19.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.53
Rate for Payer: Hamaspik Choice Inc Medicare	$28.53

TROCHANTERIC PLATE

Facility

$4,368.00

Service Code	HCPCS C1713
Hospital Charge Code	40209865
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,586.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,402.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,620.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,511.60
Rate for Payer: EmblemHealth Commercial	$2,184.00
Rate for Payer: Fidelis Medicare Advantage	$4,586.40
Rate for Payer: Group Health Inc Commercial	$2,184.00
Rate for Payer: Group Health Inc Medicare	$1,528.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,184.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,839.20

Know your out-of-pocket cost for care.

All Charges