St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TW DRILL W STOP

Facility

$281.78

Service Code	HCPCS C1713
Hospital Charge Code	64904390
Hospital Revenue Code	278
Min. Negotiated Rate	$140.89
Max. Negotiated Rate	$140.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.89
Rate for Payer: Hamaspik Choice Inc Medicare	$140.89

TW DRILL W STOP

Facility

$281.78

Service Code	HCPCS C1713
Hospital Charge Code	64904390
Hospital Revenue Code	278
Min. Negotiated Rate	$98.62
Max. Negotiated Rate	$295.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$169.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$140.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$162.02
Rate for Payer: EmblemHealth Commercial	$140.89
Rate for Payer: Fidelis Medicare Advantage	$295.87
Rate for Payer: Group Health Inc Commercial	$140.89
Rate for Payer: Group Health Inc Medicare	$98.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.89
Rate for Payer: Hamaspik Choice Inc Medicare	$140.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$183.16

TW DRL/1.6MM 5MM

Facility

$193.88

Hospital Charge Code	40005861
Hospital Revenue Code	272
Min. Negotiated Rate	$67.86
Max. Negotiated Rate	$155.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$106.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$96.94
Rate for Payer: Aetna Government	$96.94
Rate for Payer: Brighton Health Commercial	$145.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.84
Rate for Payer: Group Health Inc Commercial	$96.94
Rate for Payer: Group Health Inc Medicare	$67.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$96.94
Rate for Payer: Hamaspik Choice Inc Medicare	$96.94

TW DRL/1.6MM 5MM

Facility

$242.35

Service Code	HCPCS C1713
Hospital Charge Code	64903289
Hospital Revenue Code	278
Min. Negotiated Rate	$84.82
Max. Negotiated Rate	$254.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$145.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$121.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.35
Rate for Payer: EmblemHealth Commercial	$121.18
Rate for Payer: Fidelis Medicare Advantage	$254.47
Rate for Payer: Group Health Inc Commercial	$121.18
Rate for Payer: Group Health Inc Medicare	$84.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.18
Rate for Payer: Hamaspik Choice Inc Medicare	$121.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$157.53

TW DRL/1.6MM 5MM

Facility

$242.35

Service Code	HCPCS C1713
Hospital Charge Code	64903289
Hospital Revenue Code	278
Min. Negotiated Rate	$121.18
Max. Negotiated Rate	$121.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.18
Rate for Payer: Hamaspik Choice Inc Medicare	$121.18

TW DRL/1.6MM 7MM STRYKER

Facility

$294.48

Hospital Charge Code	40005862
Hospital Revenue Code	272
Min. Negotiated Rate	$103.07
Max. Negotiated Rate	$235.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$161.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$147.24
Rate for Payer: Aetna Government	$147.24
Rate for Payer: Brighton Health Commercial	$220.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$235.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.25
Rate for Payer: Group Health Inc Commercial	$147.24
Rate for Payer: Group Health Inc Medicare	$103.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$147.24
Rate for Payer: Hamaspik Choice Inc Medicare	$147.24

TWIST DRILL 1.1MM DIA X50MM CYLIN

Facility

$248.00

Hospital Charge Code	40200844
Hospital Revenue Code	270
Min. Negotiated Rate	$86.80
Max. Negotiated Rate	$198.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$124.00
Rate for Payer: Aetna Government	$124.00
Rate for Payer: Brighton Health Commercial	$186.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.64
Rate for Payer: Group Health Inc Commercial	$124.00
Rate for Payer: Group Health Inc Medicare	$86.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$124.00
Rate for Payer: Hamaspik Choice Inc Medicare	$124.00

TWIST DRILL 1.1MM DIAX50 W/NOTCH

Facility

$224.00

Hospital Charge Code	40200845
Hospital Revenue Code	270
Min. Negotiated Rate	$78.40
Max. Negotiated Rate	$179.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$112.00
Rate for Payer: Aetna Government	$112.00
Rate for Payer: Brighton Health Commercial	$168.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$179.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$152.32
Rate for Payer: Group Health Inc Commercial	$112.00
Rate for Payer: Group Health Inc Medicare	$78.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.00
Rate for Payer: Hamaspik Choice Inc Medicare	$112.00

TWIST DRILL2.2MM DIA X 70MM CYLIN

Facility

$224.00

Hospital Charge Code	40200846
Hospital Revenue Code	270
Min. Negotiated Rate	$78.40
Max. Negotiated Rate	$179.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$112.00
Rate for Payer: Aetna Government	$112.00
Rate for Payer: Brighton Health Commercial	$168.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$179.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$152.32
Rate for Payer: Group Health Inc Commercial	$112.00
Rate for Payer: Group Health Inc Medicare	$78.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.00
Rate for Payer: Hamaspik Choice Inc Medicare	$112.00

TWIST DRILL 2.2X 105

Facility

$224.00

Service Code	HCPCS C1713
Hospital Charge Code	40200389
Hospital Revenue Code	278
Min. Negotiated Rate	$78.40
Max. Negotiated Rate	$235.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$134.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.80
Rate for Payer: EmblemHealth Commercial	$112.00
Rate for Payer: Fidelis Medicare Advantage	$235.20
Rate for Payer: Group Health Inc Commercial	$112.00
Rate for Payer: Group Health Inc Medicare	$78.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.00
Rate for Payer: Hamaspik Choice Inc Medicare	$112.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$145.60

TWIST DRILL 2.2X 105

Facility

$224.00

Service Code	HCPCS C1713
Hospital Charge Code	40200389
Hospital Revenue Code	278
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$112.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.00
Rate for Payer: Hamaspik Choice Inc Medicare	$112.00

TWISTER PLS ROTBLE DEVICE 22MM

Facility

$201.29

Hospital Charge Code	64905534
Hospital Revenue Code	270
Min. Negotiated Rate	$70.45
Max. Negotiated Rate	$161.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.64
Rate for Payer: Aetna Government	$100.64
Rate for Payer: Brighton Health Commercial	$150.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$161.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.88
Rate for Payer: Group Health Inc Commercial	$100.64
Rate for Payer: Group Health Inc Medicare	$70.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.64
Rate for Payer: Hamaspik Choice Inc Medicare	$100.64

TWISTER WIRE 7 BLUNT

Facility

$402.50

Hospital Charge Code	64904652
Hospital Revenue Code	270
Min. Negotiated Rate	$140.88
Max. Negotiated Rate	$322.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$221.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$201.25
Rate for Payer: Aetna Government	$201.25
Rate for Payer: Brighton Health Commercial	$301.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$322.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$273.70
Rate for Payer: Group Health Inc Commercial	$201.25
Rate for Payer: Group Health Inc Medicare	$140.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$201.25
Rate for Payer: Hamaspik Choice Inc Medicare	$201.25

TWISTR PLS ROTABLE DEVICE 26MM

Facility

$201.29

Hospital Charge Code	64905536
Hospital Revenue Code	270
Min. Negotiated Rate	$70.45
Max. Negotiated Rate	$161.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.64
Rate for Payer: Aetna Government	$100.64
Rate for Payer: Brighton Health Commercial	$150.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$161.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.88
Rate for Payer: Group Health Inc Commercial	$100.64
Rate for Payer: Group Health Inc Medicare	$70.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.64
Rate for Payer: Hamaspik Choice Inc Medicare	$100.64

TX CONTOUR DEFECTS 1.1 TO 5CC

Facility

$1,505.35

Service Code	HCPCS 11951
Hospital Charge Code	30307788
Hospital Revenue Code	510
Min. Negotiated Rate	$233.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$726.29
Rate for Payer: Aetna Government	$726.29
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$726.29
Rate for Payer: Cash Price	$726.29
Rate for Payer: Cash Price	$726.29
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$726.29
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	$726.29
Rate for Payer: Fidelis Essential Plan Aliesa	$617.35
Rate for Payer: Fidelis Essential Plan QHP	$646.40
Rate for Payer: Fidelis Medicare Advantage	$726.29
Rate for Payer: Fidelis Qualified Health Plan	$646.40
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	$752.68
Rate for Payer: Hamaspik Choice Inc Medicare	$726.29
Rate for Payer: Healthfirst Medicare Advantage	$617.35
Rate for Payer: Healthfirst QHP	$726.29
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$726.29
Rate for Payer: Senior Whole Health Medicare Advantage	$726.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$726.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$581.03
Rate for Payer: Wellcare Medicare	$689.98

TX CONTOUR DEFECTS 1.1 TO 5CC

Facility

$1,505.35

Service Code	HCPCS 11951
Hospital Charge Code	30307788
Hospital Revenue Code	510
Rate for Payer: Cash Price	$726.29

TX CONTOUR DEFECTS 1CC/<

Facility

$507.72

Service Code	HCPCS 11950
Hospital Charge Code	30307888
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	$253.86
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

TX CONTOUR DEFECTS 1CC/<

Facility

$507.72

Service Code	HCPCS 11950
Hospital Charge Code	30307888
Hospital Revenue Code	510
Rate for Payer: Cash Price	$231.52

TX,DX IV PUSH INT ARTERIAL INTIAL

Facility

$556.50

Service Code	HCPCS 96374
Hospital Charge Code	40509878
Hospital Revenue Code	269
Rate for Payer: Cash Price	$247.87

TX,DX IV PUSH INT ARTERIAL INTIAL

Facility

$556.50

Service Code	HCPCS 96374
Hospital Charge Code	40509878
Hospital Revenue Code	269
Min. Negotiated Rate	$198.30
Max. Negotiated Rate	$445.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$306.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$247.87
Rate for Payer: Aetna Government	$247.87
Rate for Payer: Brighton Health Commercial	$417.38
Rate for Payer: Cash Price	$247.87
Rate for Payer: Cash Price	$247.87
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$247.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$445.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$378.42
Rate for Payer: Elderplan Medicare Advantage	$247.87
Rate for Payer: EmblemHealth Commercial	$247.87
Rate for Payer: Fidelis Essential Plan Aliesa	$210.69
Rate for Payer: Fidelis Essential Plan QHP	$220.60
Rate for Payer: Fidelis Medicare Advantage	$247.87
Rate for Payer: Fidelis Qualified Health Plan	$220.60
Rate for Payer: Group Health Inc Commercial	$247.87
Rate for Payer: Group Health Inc Medicare	$247.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$278.25
Rate for Payer: Hamaspik Choice Inc Medicare	$247.87
Rate for Payer: Healthfirst Medicare Advantage	$210.69
Rate for Payer: Healthfirst QHP	$247.87
Rate for Payer: Senior Whole Health Medicare Advantage	$247.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$247.87
Rate for Payer: Wellcare CHP/FHP/Medicaid	$198.30
Rate for Payer: Wellcare Medicare	$235.48

TX FRACTURE FINGER/TOE/TRUNK

Facility

$629.62

Service Code	HCPCS 28515
Hospital Charge Code	30105538
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$272.71
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
Rate for Payer: Group Health Inc Commercial	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$314.81
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$272.71
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

TX FRACTURE FINGER/TOE/TRUNK

Facility

$629.62

Service Code	HCPCS 28515
Hospital Charge Code	30105538
Hospital Revenue Code	450
Rate for Payer: Cash Price	$272.71

TX FX ULNA W/MANIPULATION

Facility

$653.13

Service Code	HCPCS 25535
Hospital Charge Code	30306516
Hospital Revenue Code	510
Min. Negotiated Rate	$218.17
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
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	$326.56
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst Medicare Advantage	$231.80
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$272.71
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

TX FX ULNA W/MANIPULATION

Facility

$653.13

Service Code	HCPCS 25535
Hospital Charge Code	30306516
Hospital Revenue Code	510
Rate for Payer: Cash Price	$272.71

TX GASTRO INTUB W/ASP

Facility

$766.58

Service Code	HCPCS 43753
Hospital Charge Code	40019720
Hospital Revenue Code	360
Rate for Payer: Cash Price	$362.98

Know your out-of-pocket cost for care.

All Charges