St. Barnabas Hospital

All Charges

Charge

Type

Price

CANNULA PS BU

Facility IP

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	64903638
Hospital Revenue Code	278
Min. Negotiated Rate	$57.50
Max. Negotiated Rate	$57.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.50
Rate for Payer: Hamaspik Choice Inc Medicare	$57.50

CANNULA, SOFTECH, 7' SAMPLE LINE

Facility OP

$5.70

Hospital Charge Code	64904160
Hospital Revenue Code	270
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$4.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.85
Rate for Payer: Aetna Government	$2.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.88
Rate for Payer: Group Health Inc Commercial	$2.85
Rate for Payer: Group Health Inc Medicare	$2.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.85
Rate for Payer: Hamaspik Choice Inc Medicare	$2.85

CANNULATED DRILL BIT 3MM

Facility IP

$437.50

Service Code	HCPCS C1713
Hospital Charge Code	64903695
Hospital Revenue Code	278
Min. Negotiated Rate	$218.75
Max. Negotiated Rate	$218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$218.75
Rate for Payer: Hamaspik Choice Inc Medicare	$218.75

CANNULATED DRILL BIT 3MM

Facility OP

$437.50

Service Code	HCPCS C1713
Hospital Charge Code	64903695
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$459.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$240.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$218.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$251.56
Rate for Payer: Fidelis Medicare Advantage	$459.38
Rate for Payer: Group Health Inc Commercial	$218.75
Rate for Payer: Group Health Inc Medicare	$153.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$218.75
Rate for Payer: Hamaspik Choice Inc Medicare	$218.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$284.38

CANNULATED DRILL BIT 4.5MM

Facility IP

$487.50

Service Code	HCPCS C1713
Hospital Charge Code	64903697
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75

CANNULATED DRILL BIT 4.5MM

Facility OP

$487.50

Service Code	HCPCS C1713
Hospital Charge Code	64903697
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$511.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$243.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$280.31
Rate for Payer: Fidelis Medicare Advantage	$511.88
Rate for Payer: Group Health Inc Commercial	$243.75
Rate for Payer: Group Health Inc Medicare	$170.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.88

CANNULATED DRILL BIT 6.7MM

Facility OP

$487.50

Service Code	HCPCS C1713
Hospital Charge Code	64903703
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$511.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$243.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$280.31
Rate for Payer: Fidelis Medicare Advantage	$511.88
Rate for Payer: Group Health Inc Commercial	$243.75
Rate for Payer: Group Health Inc Medicare	$170.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.88

CANNULATED DRILL BIT 6.7MM

Facility IP

$487.50

Service Code	HCPCS C1713
Hospital Charge Code	64903703
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75

CANNULA TWIST-IN

Facility OP

$90.00

Hospital Charge Code	64905829
Hospital Revenue Code	270
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

CANNULA TWIST IN 7MM X 7CM

Facility OP

$62.50

Hospital Charge Code	64904998
Hospital Revenue Code	270
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$50.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.25
Rate for Payer: Aetna Government	$31.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.50
Rate for Payer: Group Health Inc Commercial	$31.25
Rate for Payer: Group Health Inc Medicare	$21.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.25
Rate for Payer: Hamaspik Choice Inc Medicare	$31.25

CANNULA, VACURETTE,F TIP, 6MM

Facility OP

$11.25

Hospital Charge Code	64904127
Hospital Revenue Code	270
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$9.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.62
Rate for Payer: Aetna Government	$5.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.65
Rate for Payer: Group Health Inc Commercial	$5.62
Rate for Payer: Group Health Inc Medicare	$3.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.62
Rate for Payer: Hamaspik Choice Inc Medicare	$5.62

CANNUL DRILL 2.7MM AO FITT

Facility IP

$1,172.50

Service Code	HCPCS C1713
Hospital Charge Code	64904579
Hospital Revenue Code	278
Min. Negotiated Rate	$586.25
Max. Negotiated Rate	$586.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.25
Rate for Payer: Hamaspik Choice Inc Medicare	$586.25

CANNUL DRILL 2.7MM AO FITT

Facility OP

$1,172.50

Service Code	HCPCS C1713
Hospital Charge Code	64904579
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,231.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$644.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$586.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$674.19
Rate for Payer: Fidelis Medicare Advantage	$1,231.12
Rate for Payer: Group Health Inc Commercial	$586.25
Rate for Payer: Group Health Inc Medicare	$410.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.25
Rate for Payer: Hamaspik Choice Inc Medicare	$586.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$762.12

CANNUL DRILL 3.5MM AO FITTI

Facility OP

$1,172.50

Service Code	HCPCS C1713
Hospital Charge Code	64904561
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,231.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$644.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$586.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$674.19
Rate for Payer: Fidelis Medicare Advantage	$1,231.12
Rate for Payer: Group Health Inc Commercial	$586.25
Rate for Payer: Group Health Inc Medicare	$410.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.25
Rate for Payer: Hamaspik Choice Inc Medicare	$586.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$762.12

CANNUL DRILL 3.5MM AO FITTI

Facility IP

$1,172.50

Service Code	HCPCS C1713
Hospital Charge Code	64904561
Hospital Revenue Code	278
Min. Negotiated Rate	$586.25
Max. Negotiated Rate	$586.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.25
Rate for Payer: Hamaspik Choice Inc Medicare	$586.25

CANNUL DRILL 4.9MM LARGE AO

Facility OP

$1,172.50

Service Code	HCPCS C1713
Hospital Charge Code	64904732
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,231.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$644.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$586.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$674.19
Rate for Payer: Fidelis Medicare Advantage	$1,231.12
Rate for Payer: Group Health Inc Commercial	$586.25
Rate for Payer: Group Health Inc Medicare	$410.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.25
Rate for Payer: Hamaspik Choice Inc Medicare	$586.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$762.12

CANNUL DRILL 4.9MM LARGE AO

Facility IP

$1,172.50

Service Code	HCPCS C1713
Hospital Charge Code	64904732
Hospital Revenue Code	278
Min. Negotiated Rate	$586.25
Max. Negotiated Rate	$586.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.25
Rate for Payer: Hamaspik Choice Inc Medicare	$586.25

CANTHOTOMY

Facility OP

$5,861.23

Service Code	HCPCS 67715
Hospital Charge Code	30106628
Hospital Revenue Code	450
Min. Negotiated Rate	$118.62
Max. Negotiated Rate	$2,930.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,702.32
Rate for Payer: Aetna Government	$2,702.32
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$2,702.32
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$2,702.32
Rate for Payer: Cash Price	$2,702.32
Rate for Payer: Cash Price	$2,702.32
Rate for Payer: Cash Price	$2,702.32
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,702.32
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	$2,702.32
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$118.62
Rate for Payer: Fidelis Essential Plan Aliesa	$2,296.97
Rate for Payer: Fidelis Essential Plan QHP	$2,405.06
Rate for Payer: Fidelis Medicare Advantage	$2,702.32
Rate for Payer: Fidelis Qualified Health Plan	$2,405.06
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	$2,930.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,702.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$2,702.32
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$2,702.32
Rate for Payer: Senior Whole Health Medicare Advantage	$2,702.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,702.32
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,161.86
Rate for Payer: Wellcare Medicare	$2,567.20

C ANTIGEN TYPE

Facility OP

$858.38

Service Code	HCPCS 86905
Hospital Charge Code	40701250
Hospital Revenue Code	300
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$472.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$472.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$415.67
Rate for Payer: Aetna Government	$415.67
Rate for Payer: Cash Price	$415.67
Rate for Payer: Cash Price	$415.67
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$415.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.15
Rate for Payer: Elderplan Medicare Advantage	$415.67
Rate for Payer: EmblemHealth Commercial	$415.67
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.45
Rate for Payer: Fidelis Essential Plan Aliesa	$353.32
Rate for Payer: Fidelis Essential Plan QHP	$369.95
Rate for Payer: Fidelis Medicare Advantage	$415.67
Rate for Payer: Fidelis Qualified Health Plan	$369.95
Rate for Payer: Group Health Inc Commercial	$415.67
Rate for Payer: Group Health Inc Medicare	$415.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$429.19
Rate for Payer: Hamaspik Choice Inc Medicare	$415.67
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3.83
Rate for Payer: Healthfirst Medicare Advantage	$415.67
Rate for Payer: Healthfirst QHP	$415.67
Rate for Payer: Senior Whole Health Medicare Advantage	$415.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$415.67
Rate for Payer: Wellcare CHP/FHP/Medicaid	$332.54
Rate for Payer: Wellcare Medicare	$374.10

CANTON BAG

Facility OP

$9.57

Hospital Charge Code	40200902
Hospital Revenue Code	270
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$7.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.78
Rate for Payer: Aetna Government	$4.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.51
Rate for Payer: Group Health Inc Commercial	$4.78
Rate for Payer: Group Health Inc Medicare	$3.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.78
Rate for Payer: Hamaspik Choice Inc Medicare	$4.78

CANTOR TUBE

Facility OP

$99.23

Hospital Charge Code	40200903
Hospital Revenue Code	270
Min. Negotiated Rate	$34.73
Max. Negotiated Rate	$79.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$54.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$49.62
Rate for Payer: Aetna Government	$49.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.48
Rate for Payer: Group Health Inc Commercial	$49.62
Rate for Payer: Group Health Inc Medicare	$34.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.62
Rate for Payer: Hamaspik Choice Inc Medicare	$49.62

CAP,CONT CLUSTER-H 54JJ

Facility OP

$5,595.00

Hospital Charge Code	64905557
Hospital Revenue Code	279
Min. Negotiated Rate	$1,958.25
Max. Negotiated Rate	$4,476.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,077.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,797.50
Rate for Payer: Aetna Government	$2,797.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,476.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,804.60
Rate for Payer: Group Health Inc Commercial	$2,797.50
Rate for Payer: Group Health Inc Medicare	$1,958.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,797.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,797.50

CAP,CONT CLUSTR-H 54II

Facility OP

$4,750.00

Hospital Charge Code	64905559
Hospital Revenue Code	279
Min. Negotiated Rate	$1,662.50
Max. Negotiated Rate	$3,800.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,612.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,375.00
Rate for Payer: Aetna Government	$2,375.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,800.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,230.00
Rate for Payer: Group Health Inc Commercial	$2,375.00
Rate for Payer: Group Health Inc Medicare	$1,662.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,375.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,375.00

CAPD/COMPOSITE-1/2 DAY

Facility OP

$164.07

Hospital Charge Code	42901842
Hospital Revenue Code	841
Min. Negotiated Rate	$82.04
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$82.04
Rate for Payer: Aetna Government	$82.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$620.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$527.09
Rate for Payer: EmblemHealth Commercial	$445.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$150.00
Rate for Payer: Fidelis Essential Plan Aliesa	$150.00
Rate for Payer: Fidelis Essential Plan QHP	$159.00
Rate for Payer: Fidelis Qualified Health Plan	$158.00
Rate for Payer: Group Health Inc Commercial	$650.00
Rate for Payer: Group Health Inc Medicare	$435.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.04
Rate for Payer: Hamaspik Choice Inc Medicare	$82.04
Rate for Payer: Wellcare Medicare	$370.00

CAP EXTERNAL FIXATION 5MM D

Facility OP

$121.88

Service Code	HCPCS C1713
Hospital Charge Code	64902226
Hospital Revenue Code	278
Min. Negotiated Rate	$42.66
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$70.08
Rate for Payer: Fidelis Medicare Advantage	$127.97
Rate for Payer: Group Health Inc Commercial	$60.94
Rate for Payer: Group Health Inc Medicare	$42.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.94
Rate for Payer: Hamaspik Choice Inc Medicare	$60.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$79.22

Price Transparency.

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