St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

VITRECTOMY

Facility

$6,123.70

Service Code	HCPCS 67010
Hospital Charge Code	40072565
Hospital Revenue Code	360
Rate for Payer: Cash Price	$2,694.88

VITRECTOMY

Facility

$6,123.70

Service Code	HCPCS 67010
Hospital Charge Code	40072565
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$4,592.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,694.88
Rate for Payer: Aetna Government	$2,694.88
Rate for Payer: Brighton Health Commercial	$4,592.78
Rate for Payer: Cash Price	$2,694.88
Rate for Payer: Cash Price	$2,694.88
Rate for Payer: Cash Price	$2,694.88
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,694.88
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	$2,694.88
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$2,290.65
Rate for Payer: Fidelis Essential Plan QHP	$2,398.44
Rate for Payer: Fidelis Medicare Advantage	$2,694.88
Rate for Payer: Fidelis Qualified Health Plan	$2,398.44
Rate for Payer: Group Health Inc Commercial	$2,694.88
Rate for Payer: Group Health Inc Medicare	$2,694.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,061.85
Rate for Payer: Hamaspik Choice Inc Medicare	$2,694.88
Rate for Payer: Healthfirst Medicare Advantage	$2,290.65
Rate for Payer: Healthfirst QHP	$2,694.88
Rate for Payer: Senior Whole Health Medicare Advantage	$2,694.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,694.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,155.90
Rate for Payer: Wellcare Medicare	$2,560.14

VIVACIT-E HICR PO R 12MM

Facility

$4,250.00

Hospital Charge Code	64905311
Hospital Revenue Code	279
Min. Negotiated Rate	$1,487.50
Max. Negotiated Rate	$3,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,337.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,125.00
Rate for Payer: Aetna Government	$2,125.00
Rate for Payer: Brighton Health Commercial	$3,187.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,890.00
Rate for Payer: Group Health Inc Commercial	$2,125.00
Rate for Payer: Group Health Inc Medicare	$1,487.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00

VIVACIT-E HICR PO R 29MM

Facility

$2,000.00

Hospital Charge Code	64905314
Hospital Revenue Code	279
Min. Negotiated Rate	$700.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,000.00
Rate for Payer: Aetna Government	$1,000.00
Rate for Payer: Brighton Health Commercial	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,360.00
Rate for Payer: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

VIVA XI CARDIOVERTER DEFIBRILLATO

Facility

$22,868.00

Service Code	HCPCS C1882
Hospital Charge Code	41646657
Hospital Revenue Code	275
Min. Negotiated Rate	$4,752.01
Max. Negotiated Rate	$24,011.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12,577.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,752.01
Rate for Payer: Aetna Government	$4,752.01
Rate for Payer: Brighton Health Commercial	$13,720.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11,434.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13,149.10
Rate for Payer: EmblemHealth Commercial	$11,434.00
Rate for Payer: Fidelis Medicare Advantage	$24,011.40
Rate for Payer: Group Health Inc Commercial	$11,434.00
Rate for Payer: Group Health Inc Medicare	$8,003.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,434.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,434.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14,864.20

VIVA XI CARDIOVERTER DEFIBRILLATO

Facility

$53,144.00

Service Code	HCPCS C1882
Hospital Charge Code	66576908
Hospital Revenue Code	275
Min. Negotiated Rate	$4,752.01
Max. Negotiated Rate	$55,801.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29,229.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,752.01
Rate for Payer: Aetna Government	$4,752.01
Rate for Payer: Brighton Health Commercial	$31,886.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26,572.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$30,557.80
Rate for Payer: EmblemHealth Commercial	$26,572.00
Rate for Payer: Fidelis Medicare Advantage	$55,801.20
Rate for Payer: Group Health Inc Commercial	$26,572.00
Rate for Payer: Group Health Inc Medicare	$18,600.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,572.00
Rate for Payer: Hamaspik Choice Inc Medicare	$26,572.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34,543.60

VMA, RANDOM URINE

Facility

$12.95

Service Code	HCPCS 82570
Hospital Charge Code	40609061
Hospital Revenue Code	300
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$9.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.18
Rate for Payer: Aetna Government	$5.18
Rate for Payer: Brighton Health Commercial	$9.71
Rate for Payer: Cash Price	$5.18
Rate for Payer: Cash Price	$5.18
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.96
Rate for Payer: Elderplan Medicare Advantage	$5.18
Rate for Payer: EmblemHealth Commercial	$5.18
Rate for Payer: Fidelis Essential Plan Aliesa	$4.40
Rate for Payer: Fidelis Essential Plan QHP	$4.61
Rate for Payer: Fidelis Medicare Advantage	$5.18
Rate for Payer: Fidelis Qualified Health Plan	$4.61
Rate for Payer: Group Health Inc Commercial	$5.18
Rate for Payer: Group Health Inc Medicare	$5.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.48
Rate for Payer: Hamaspik Choice Inc Medicare	$5.18
Rate for Payer: Healthfirst Medicare Advantage	$5.18
Rate for Payer: Healthfirst QHP	$5.18
Rate for Payer: Senior Whole Health Medicare Advantage	$5.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.14
Rate for Payer: Wellcare Medicare	$4.66

VMA, RANDOM URINE

Facility

$12.95

Service Code	HCPCS 82570
Hospital Charge Code	40609061
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.18

VNGRD DCM CRTIB BEAR 10MMX63/67MM

Facility

$2,298.00

Service Code	HCPCS C1776
Hospital Charge Code	40202214
Hospital Revenue Code	278
Min. Negotiated Rate	$1,149.00
Max. Negotiated Rate	$1,149.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,149.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,149.00

VNGRD DCM CRTIB BEAR 10MMX63/67MM

Facility

$2,298.00

Service Code	HCPCS C1776
Hospital Charge Code	40202214
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,412.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,263.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,378.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,149.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,321.35
Rate for Payer: EmblemHealth Commercial	$1,149.00
Rate for Payer: Fidelis Medicare Advantage	$2,412.90
Rate for Payer: Group Health Inc Commercial	$1,149.00
Rate for Payer: Group Health Inc Medicare	$804.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,149.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,149.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,493.70

VNGRD DCM CRTIB BEAR 14MMX63/67MM

Facility

$2,208.00

Service Code	HCPCS C1776
Hospital Charge Code	40202215
Hospital Revenue Code	278
Min. Negotiated Rate	$1,104.00
Max. Negotiated Rate	$1,104.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,104.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,104.00

VNGRD DCM CRTIB BEAR 14MMX63/67MM

Facility

$2,208.00

Service Code	HCPCS C1776
Hospital Charge Code	40202215
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,318.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,214.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,324.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,104.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,269.60
Rate for Payer: EmblemHealth Commercial	$1,104.00
Rate for Payer: Fidelis Medicare Advantage	$2,318.40
Rate for Payer: Group Health Inc Commercial	$1,104.00
Rate for Payer: Group Health Inc Medicare	$772.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,104.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,104.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,435.20

VNGRD DCM CR TIB BR 16MMX63/67MM

Facility

$2,298.00

Service Code	HCPCS C1776
Hospital Charge Code	40208108
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,412.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,263.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,378.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,149.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,321.35
Rate for Payer: EmblemHealth Commercial	$1,149.00
Rate for Payer: Fidelis Medicare Advantage	$2,412.90
Rate for Payer: Group Health Inc Commercial	$1,149.00
Rate for Payer: Group Health Inc Medicare	$804.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,149.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,149.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,493.70

VNGRD DCM CR TIB BR 16MMX63/67MM

Facility

$2,298.00

Service Code	HCPCS C1776
Hospital Charge Code	40208108
Hospital Revenue Code	278
Min. Negotiated Rate	$1,149.00
Max. Negotiated Rate	$1,149.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,149.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,149.00

VOLAR PLATE RIGHT

Facility

$1,512.00

Service Code	HCPCS C1713
Hospital Charge Code	40200702
Hospital Revenue Code	278
Min. Negotiated Rate	$756.00
Max. Negotiated Rate	$756.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$756.00
Rate for Payer: Hamaspik Choice Inc Medicare	$756.00

VOLAR PLATE RIGHT

Facility

$1,512.00

Service Code	HCPCS C1713
Hospital Charge Code	40200702
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,587.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$831.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$907.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$756.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$869.40
Rate for Payer: EmblemHealth Commercial	$756.00
Rate for Payer: Fidelis Medicare Advantage	$1,587.60
Rate for Payer: Group Health Inc Commercial	$756.00
Rate for Payer: Group Health Inc Medicare	$529.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$756.00
Rate for Payer: Hamaspik Choice Inc Medicare	$756.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$982.80

VOLCANO GUIDE WIRE 10185

Facility

$1,300.00

Service Code	HCPCS C1769
Hospital Charge Code	66526674
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$1,040.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$715.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$975.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,040.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$884.00
Rate for Payer: Group Health Inc Commercial	$650.00
Rate for Payer: Group Health Inc Medicare	$455.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$650.00

VON WILLEBRAND FACTOR MULTI

Facility

$57.35

Service Code	HCPCS 85247
Hospital Charge Code	40629211
Hospital Revenue Code	300
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$43.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.94
Rate for Payer: Aetna Government	$22.94
Rate for Payer: Brighton Health Commercial	$43.01
Rate for Payer: Cash Price	$22.94
Rate for Payer: Cash Price	$22.94
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$22.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.87
Rate for Payer: Elderplan Medicare Advantage	$22.94
Rate for Payer: EmblemHealth Commercial	$22.94
Rate for Payer: Fidelis Essential Plan Aliesa	$19.50
Rate for Payer: Fidelis Essential Plan QHP	$20.42
Rate for Payer: Fidelis Medicare Advantage	$22.94
Rate for Payer: Fidelis Qualified Health Plan	$20.42
Rate for Payer: Group Health Inc Commercial	$22.94
Rate for Payer: Group Health Inc Medicare	$22.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.68
Rate for Payer: Hamaspik Choice Inc Medicare	$22.94
Rate for Payer: Healthfirst Medicare Advantage	$22.94
Rate for Payer: Healthfirst QHP	$22.94
Rate for Payer: Senior Whole Health Medicare Advantage	$22.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18.35
Rate for Payer: Wellcare Medicare	$20.65

VON WILLEBRAND FACTOR MULTI

Facility

$57.35

Service Code	HCPCS 85247
Hospital Charge Code	40629211
Hospital Revenue Code	300
Rate for Payer: Cash Price	$22.94

VORICONAZOLE 200 MG INJ

Facility

$13.44

Service Code	HCPCS J3465
Hospital Charge Code	41642870
Hospital Revenue Code	636
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$8.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.75
Rate for Payer: Aetna Government	$1.75
Rate for Payer: Brighton Health Commercial	$8.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.73
Rate for Payer: Group Health Inc Commercial	$6.72
Rate for Payer: Group Health Inc Medicare	$4.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.72
Rate for Payer: Hamaspik Choice Inc Medicare	$6.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.17
Rate for Payer: SOMOS Essential	$1.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.74

VORICONAZOLE 200 MG INJ

Facility

$13.44

Service Code	HCPCS J3465
Hospital Charge Code	41642870
Hospital Revenue Code	636
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$6.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.72
Rate for Payer: Hamaspik Choice Inc Medicare	$6.72

VORICONAZOLE 200 MG INJ

Facility

$13.44

Service Code	HCPCS J3465
Hospital Charge Code	41652870
Hospital Revenue Code	636
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$6.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.72
Rate for Payer: Hamaspik Choice Inc Medicare	$6.72

VORICONAZOLE 200 MG INJ

Facility

$13.44

Service Code	HCPCS J3465
Hospital Charge Code	41652870
Hospital Revenue Code	636
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$8.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.75
Rate for Payer: Aetna Government	$1.75
Rate for Payer: Brighton Health Commercial	$8.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.73
Rate for Payer: Group Health Inc Commercial	$6.72
Rate for Payer: Group Health Inc Medicare	$4.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.72
Rate for Payer: Hamaspik Choice Inc Medicare	$6.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.17
Rate for Payer: SOMOS Essential	$1.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.74

VORICONAZOLE 200 MG IV SOLR [33010]

Facility

$72.36

Service Code	HCPCS J3465
Hospital Charge Code	00049319028
Hospital Revenue Code	278
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$75.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.75
Rate for Payer: Aetna Government	$1.75
Rate for Payer: Brighton Health Commercial	$43.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$41.61
Rate for Payer: EmblemHealth Commercial	$36.18
Rate for Payer: Fidelis Medicare Advantage	$75.98
Rate for Payer: Group Health Inc Commercial	$36.18
Rate for Payer: Group Health Inc Medicare	$25.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.18
Rate for Payer: Hamaspik Choice Inc Medicare	$36.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$47.03

VORICONAZOLE 200 MG IV SOLR [33010]

Facility

$152.58

Service Code	HCPCS J3465
Hospital Charge Code	70436002980
Hospital Revenue Code	278
Min. Negotiated Rate	$76.29
Max. Negotiated Rate	$76.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$76.29
Rate for Payer: Hamaspik Choice Inc Medicare	$76.29

Know your out-of-pocket cost for care.

All Charges