St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TUBE JEJUNOSTOMY 14FR

Facility

$467.73

Hospital Charge Code	64902991
Hospital Revenue Code	270
Min. Negotiated Rate	$163.71
Max. Negotiated Rate	$374.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$257.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$233.86
Rate for Payer: Aetna Government	$233.86
Rate for Payer: Brighton Health Commercial	$350.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$374.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$318.06
Rate for Payer: Group Health Inc Commercial	$233.86
Rate for Payer: Group Health Inc Medicare	$163.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.86
Rate for Payer: Hamaspik Choice Inc Medicare	$233.86

TUBERCULIN PPD 5 TEST UNITS/0.1 ML INJ

Facility

$41.00

Hospital Charge Code	41642561
Hospital Revenue Code	250
Min. Negotiated Rate	$14.35
Max. Negotiated Rate	$32.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.50
Rate for Payer: Aetna Government	$20.50
Rate for Payer: Brighton Health Commercial	$30.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.88
Rate for Payer: Group Health Inc Commercial	$20.50
Rate for Payer: Group Health Inc Medicare	$14.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.50
Rate for Payer: Hamaspik Choice Inc Medicare	$20.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.65

TUBERCULIN PPD 5 TEST UNITS/0.1 ML INJ

Facility

$41.00

Hospital Charge Code	41652561
Hospital Revenue Code	250
Min. Negotiated Rate	$14.35
Max. Negotiated Rate	$32.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.50
Rate for Payer: Aetna Government	$20.50
Rate for Payer: Brighton Health Commercial	$30.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.88
Rate for Payer: Group Health Inc Commercial	$20.50
Rate for Payer: Group Health Inc Medicare	$14.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.50
Rate for Payer: Hamaspik Choice Inc Medicare	$20.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.65

TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN [8259]

Facility

$115.57

Service Code	NDC 49281075221
Hospital Charge Code	49281075221
Hospital Revenue Code	250
Min. Negotiated Rate	$40.45
Max. Negotiated Rate	$92.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.78
Rate for Payer: Aetna Government	$57.78
Rate for Payer: Brighton Health Commercial	$86.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$92.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.59
Rate for Payer: Group Health Inc Commercial	$57.78
Rate for Payer: Group Health Inc Medicare	$40.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.78
Rate for Payer: Hamaspik Choice Inc Medicare	$57.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$75.12

TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN [8259]

Facility

$106.60

Service Code	NDC 42023010401
Hospital Charge Code	42023010401
Hospital Revenue Code	250
Min. Negotiated Rate	$37.31
Max. Negotiated Rate	$85.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$53.30
Rate for Payer: Aetna Government	$53.30
Rate for Payer: Brighton Health Commercial	$79.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$85.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$72.49
Rate for Payer: Group Health Inc Commercial	$53.30
Rate for Payer: Group Health Inc Medicare	$37.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.30
Rate for Payer: Hamaspik Choice Inc Medicare	$53.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.29

TUBE SING ACTN PUMP CONT FLO DUAL

Facility

$180.50

Hospital Charge Code	64904263
Hospital Revenue Code	270
Min. Negotiated Rate	$63.18
Max. Negotiated Rate	$144.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$99.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$90.25
Rate for Payer: Aetna Government	$90.25
Rate for Payer: Brighton Health Commercial	$135.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$144.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$122.74
Rate for Payer: Group Health Inc Commercial	$90.25
Rate for Payer: Group Health Inc Medicare	$63.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.25
Rate for Payer: Hamaspik Choice Inc Medicare	$90.25

TUBE SINGLE ACTION CONT FLOW DUAL

Facility

$125.20

Hospital Charge Code	40205988
Hospital Revenue Code	270
Min. Negotiated Rate	$43.82
Max. Negotiated Rate	$100.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.60
Rate for Payer: Aetna Government	$62.60
Rate for Payer: Brighton Health Commercial	$93.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.14
Rate for Payer: Group Health Inc Commercial	$62.60
Rate for Payer: Group Health Inc Medicare	$43.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.60
Rate for Payer: Hamaspik Choice Inc Medicare	$62.60

TUBE SINGLE ACTION PUMP

Facility

$112.00

Hospital Charge Code	40205987
Hospital Revenue Code	270
Min. Negotiated Rate	$39.20
Max. Negotiated Rate	$89.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.00
Rate for Payer: Aetna Government	$56.00
Rate for Payer: Brighton Health Commercial	$84.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.16
Rate for Payer: Group Health Inc Commercial	$56.00
Rate for Payer: Group Health Inc Medicare	$39.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.00
Rate for Payer: Hamaspik Choice Inc Medicare	$56.00

TUBES (LOHEN SPEC. COLL.)

Facility

$6.73

Hospital Charge Code	40206008
Hospital Revenue Code	270
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.36
Rate for Payer: Aetna Government	$3.36
Rate for Payer: Brighton Health Commercial	$5.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.36
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.36
Rate for Payer: Hamaspik Choice Inc Medicare	$3.36

TUBE TRACH 7.0XLT DIS EXT CUF

Facility

$180.00

Hospital Charge Code	64904463
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

TUBE TRACHEAL 5.5 CUFFED ORAL

Facility

$207.28

Hospital Charge Code	64903050
Hospital Revenue Code	270
Min. Negotiated Rate	$72.55
Max. Negotiated Rate	$165.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$114.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$103.64
Rate for Payer: Aetna Government	$103.64
Rate for Payer: Brighton Health Commercial	$155.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$165.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.95
Rate for Payer: Group Health Inc Commercial	$103.64
Rate for Payer: Group Health Inc Medicare	$72.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$103.64
Rate for Payer: Hamaspik Choice Inc Medicare	$103.64

TUBE TRACH MID-RANG HYPRFLX 7MM

Facility

$418.45

Hospital Charge Code	64904898
Hospital Revenue Code	270
Min. Negotiated Rate	$146.46
Max. Negotiated Rate	$334.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$209.22
Rate for Payer: Aetna Government	$209.22
Rate for Payer: Brighton Health Commercial	$313.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$334.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.55
Rate for Payer: Group Health Inc Commercial	$209.22
Rate for Payer: Group Health Inc Medicare	$146.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.22
Rate for Payer: Hamaspik Choice Inc Medicare	$209.22

TUBE TRACH PROXIMAL 7.0 XLT

Facility

$143.10

Hospital Charge Code	64904265
Hospital Revenue Code	270
Min. Negotiated Rate	$50.08
Max. Negotiated Rate	$114.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$78.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$71.55
Rate for Payer: Aetna Government	$71.55
Rate for Payer: Brighton Health Commercial	$107.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.31
Rate for Payer: Group Health Inc Commercial	$71.55
Rate for Payer: Group Health Inc Medicare	$50.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.55
Rate for Payer: Hamaspik Choice Inc Medicare	$71.55

TUBE VACUTAINERBLUE TOP

Facility

$1.02

Hospital Charge Code	40209464
Hospital Revenue Code	270
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.51
Rate for Payer: Aetna Government	$0.51
Rate for Payer: Brighton Health Commercial	$0.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.69
Rate for Payer: Group Health Inc Commercial	$0.51
Rate for Payer: Group Health Inc Medicare	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.51
Rate for Payer: Hamaspik Choice Inc Medicare	$0.51

TUBE VACUTAINERGOLD TOP

Facility

$0.32

Hospital Charge Code	40209463
Hospital Revenue Code	270
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.16
Rate for Payer: Aetna Government	$0.16
Rate for Payer: Brighton Health Commercial	$0.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.22
Rate for Payer: Group Health Inc Commercial	$0.16
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16

TUBE VACUTAINER PURPLE TOP 367856

Facility

$1.22

Hospital Charge Code	40209462
Hospital Revenue Code	270
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$0.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.61
Rate for Payer: Aetna Government	$0.61
Rate for Payer: Brighton Health Commercial	$0.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.83
Rate for Payer: Group Health Inc Commercial	$0.61
Rate for Payer: Group Health Inc Medicare	$0.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.61
Rate for Payer: Hamaspik Choice Inc Medicare	$0.61

TUBE VACUTAINER RED TOP 10ML 7820

Facility

$1.44

Hospital Charge Code	40209465
Hospital Revenue Code	270
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.72
Rate for Payer: Aetna Government	$0.72
Rate for Payer: Brighton Health Commercial	$1.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.98
Rate for Payer: Group Health Inc Commercial	$0.72
Rate for Payer: Group Health Inc Medicare	$0.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.72
Rate for Payer: Hamaspik Choice Inc Medicare	$0.72

TUBE VACUT STRL BLUE 1.8ML

Facility

$126.23

Hospital Charge Code	64902805
Hospital Revenue Code	270
Min. Negotiated Rate	$44.18
Max. Negotiated Rate	$100.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.12
Rate for Payer: Aetna Government	$63.12
Rate for Payer: Brighton Health Commercial	$94.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.84
Rate for Payer: Group Health Inc Commercial	$63.12
Rate for Payer: Group Health Inc Medicare	$44.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.12
Rate for Payer: Hamaspik Choice Inc Medicare	$63.12

TUBE VENTD BVL'D GRMMT SZ 1 1.14

Facility

$28.40

Hospital Charge Code	64906758
Hospital Revenue Code	270
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$22.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.20
Rate for Payer: Aetna Government	$14.20
Rate for Payer: Brighton Health Commercial	$21.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.31
Rate for Payer: Group Health Inc Commercial	$14.20
Rate for Payer: Group Health Inc Medicare	$9.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.20
Rate for Payer: Hamaspik Choice Inc Medicare	$14.20

TUBE VENT FLURO WHT BEVEL 1.14MM

Facility

$270.00

Hospital Charge Code	64906680
Hospital Revenue Code	270
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$216.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$135.00
Rate for Payer: Aetna Government	$135.00
Rate for Payer: Brighton Health Commercial	$202.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$216.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.60
Rate for Payer: Group Health Inc Commercial	$135.00
Rate for Payer: Group Health Inc Medicare	$94.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.00
Rate for Payer: Hamaspik Choice Inc Medicare	$135.00

TUBING, ARTHROSCOPY

Facility

$3,116.00

Hospital Charge Code	40203150
Hospital Revenue Code	272
Min. Negotiated Rate	$1,090.60
Max. Negotiated Rate	$2,492.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,713.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,558.00
Rate for Payer: Aetna Government	$1,558.00
Rate for Payer: Brighton Health Commercial	$2,337.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,492.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,118.88
Rate for Payer: Group Health Inc Commercial	$1,558.00
Rate for Payer: Group Health Inc Medicare	$1,090.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,558.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,558.00

TUBING INFLOW CASSETTE

Facility

$168.20

Hospital Charge Code	64907375
Hospital Revenue Code	270
Min. Negotiated Rate	$58.87
Max. Negotiated Rate	$134.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$92.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$84.10
Rate for Payer: Aetna Government	$84.10
Rate for Payer: Brighton Health Commercial	$126.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$134.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$114.38
Rate for Payer: Group Health Inc Commercial	$84.10
Rate for Payer: Group Health Inc Medicare	$58.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$84.10
Rate for Payer: Hamaspik Choice Inc Medicare	$84.10

TUBING INSUFFLATION SET

Facility

$316.97

Hospital Charge Code	64904268
Hospital Revenue Code	270
Min. Negotiated Rate	$110.94
Max. Negotiated Rate	$253.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$158.48
Rate for Payer: Aetna Government	$158.48
Rate for Payer: Brighton Health Commercial	$237.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$253.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$215.54
Rate for Payer: Group Health Inc Commercial	$158.48
Rate for Payer: Group Health Inc Medicare	$110.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.48
Rate for Payer: Hamaspik Choice Inc Medicare	$158.48

TUBING IRRIGATION B/POLAR

Facility

$106.00

Hospital Charge Code	40205972
Hospital Revenue Code	270
Min. Negotiated Rate	$37.10
Max. Negotiated Rate	$84.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$53.00
Rate for Payer: Aetna Government	$53.00
Rate for Payer: Brighton Health Commercial	$79.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$84.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$72.08
Rate for Payer: Group Health Inc Commercial	$53.00
Rate for Payer: Group Health Inc Medicare	$37.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.00
Rate for Payer: Hamaspik Choice Inc Medicare	$53.00

TUBING, IRRIGATION SET

Facility

$2,586.00

Hospital Charge Code	40203156
Hospital Revenue Code	272
Min. Negotiated Rate	$905.10
Max. Negotiated Rate	$2,068.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,422.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,293.00
Rate for Payer: Aetna Government	$1,293.00
Rate for Payer: Brighton Health Commercial	$1,939.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,068.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,758.48
Rate for Payer: Group Health Inc Commercial	$1,293.00
Rate for Payer: Group Health Inc Medicare	$905.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,293.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,293.00

Know your out-of-pocket cost for care.

All Charges