St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

WHOLEY 145CM

Facility

$133.90

Service Code	HCPCS C1725
Hospital Charge Code	66528276
Hospital Revenue Code	278
Min. Negotiated Rate	$66.95
Max. Negotiated Rate	$66.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.95
Rate for Payer: Hamaspik Choice Inc Medicare	$66.95

WHOLEY 145CM

Facility

$133.90

Service Code	HCPCS C1725
Hospital Charge Code	66528276
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$140.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$73.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$80.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.99
Rate for Payer: EmblemHealth Commercial	$66.95
Rate for Payer: Fidelis Medicare Advantage	$140.60
Rate for Payer: Group Health Inc Commercial	$66.95
Rate for Payer: Group Health Inc Medicare	$46.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.95
Rate for Payer: Hamaspik Choice Inc Medicare	$66.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.04

WIDE EXCISN RECRNT LESN NOSE

Facility

$1,847.58

Service Code	HCPCS 11441
Hospital Charge Code	40062440
Hospital Revenue Code	360
Rate for Payer: Cash Price	$813.63

WIDE EXCISN RECRNT LESN NOSE

Facility

$1,847.58

Service Code	HCPCS 11441
Hospital Charge Code	40062440
Hospital Revenue Code	360
Min. Negotiated Rate	$650.90
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$813.63
Rate for Payer: Aetna Government	$813.63
Rate for Payer: Brighton Health Commercial	$1,385.68
Rate for Payer: Cash Price	$813.63
Rate for Payer: Cash Price	$813.63
Rate for Payer: Cash Price	$813.63
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$813.63
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	$813.63
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$691.59
Rate for Payer: Fidelis Essential Plan QHP	$724.13
Rate for Payer: Fidelis Medicare Advantage	$813.63
Rate for Payer: Fidelis Qualified Health Plan	$724.13
Rate for Payer: Group Health Inc Commercial	$813.63
Rate for Payer: Group Health Inc Medicare	$813.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$923.79
Rate for Payer: Hamaspik Choice Inc Medicare	$813.63
Rate for Payer: Healthfirst Medicare Advantage	$691.59
Rate for Payer: Healthfirst QHP	$813.63
Rate for Payer: Senior Whole Health Medicare Advantage	$813.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$813.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$650.90
Rate for Payer: Wellcare Medicare	$772.95

WINDOWING OF CAST

Facility

$405.08

Service Code	HCPCS 29730
Hospital Charge Code	40023260
Hospital Revenue Code	360
Rate for Payer: Cash Price	$182.22

WINDOWING OF CAST

Facility

$405.08

Service Code	HCPCS 29730
Hospital Charge Code	40023260
Hospital Revenue Code	360
Min. Negotiated Rate	$145.78
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$182.22
Rate for Payer: Aetna Government	$182.22
Rate for Payer: Brighton Health Commercial	$303.81
Rate for Payer: Cash Price	$182.22
Rate for Payer: Cash Price	$182.22
Rate for Payer: Cash Price	$182.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$182.22
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	$182.22
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$154.89
Rate for Payer: Fidelis Essential Plan QHP	$162.18
Rate for Payer: Fidelis Medicare Advantage	$182.22
Rate for Payer: Fidelis Qualified Health Plan	$162.18
Rate for Payer: Group Health Inc Commercial	$182.22
Rate for Payer: Group Health Inc Medicare	$182.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$202.54
Rate for Payer: Hamaspik Choice Inc Medicare	$182.22
Rate for Payer: Healthfirst Medicare Advantage	$154.89
Rate for Payer: Healthfirst QHP	$182.22
Rate for Payer: Senior Whole Health Medicare Advantage	$182.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$182.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$145.78
Rate for Payer: Wellcare Medicare	$173.11

WINDOWING OF CAST

Facility

$405.08

Service Code	HCPCS 29730
Hospital Charge Code	30302029
Hospital Revenue Code	510
Min. Negotiated Rate	$145.78
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$182.22
Rate for Payer: Aetna Government	$182.22
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$182.22
Rate for Payer: Cash Price	$182.22
Rate for Payer: Cash Price	$182.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$182.22
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	$182.22
Rate for Payer: Fidelis Essential Plan Aliesa	$154.89
Rate for Payer: Fidelis Essential Plan QHP	$162.18
Rate for Payer: Fidelis Medicare Advantage	$182.22
Rate for Payer: Fidelis Qualified Health Plan	$162.18
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	$202.54
Rate for Payer: Hamaspik Choice Inc Medicare	$182.22
Rate for Payer: Healthfirst Medicare Advantage	$154.89
Rate for Payer: Healthfirst QHP	$182.22
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$182.22
Rate for Payer: Senior Whole Health Medicare Advantage	$182.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$182.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$145.78
Rate for Payer: Wellcare Medicare	$173.11

WINDOWING OF CAST

Facility

$405.08

Service Code	HCPCS 29730
Hospital Charge Code	30302029
Hospital Revenue Code	510
Rate for Payer: Cash Price	$182.22

WIRE 2.0MM

Facility

$102.20

Service Code	HCPCS C1713
Hospital Charge Code	40200147
Hospital Revenue Code	278
Min. Negotiated Rate	$35.77
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$61.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.76
Rate for Payer: EmblemHealth Commercial	$51.10
Rate for Payer: Fidelis Medicare Advantage	$107.31
Rate for Payer: Group Health Inc Commercial	$51.10
Rate for Payer: Group Health Inc Medicare	$35.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.10
Rate for Payer: Hamaspik Choice Inc Medicare	$51.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.43

WIRE 2.0MM

Facility

$102.20

Service Code	HCPCS C1713
Hospital Charge Code	40200147
Hospital Revenue Code	278
Min. Negotiated Rate	$51.10
Max. Negotiated Rate	$51.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.10
Rate for Payer: Hamaspik Choice Inc Medicare	$51.10

WIRE 2.0MM

Facility

$130.00

Hospital Charge Code	64904069
Hospital Revenue Code	270
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$104.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$71.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.00
Rate for Payer: Aetna Government	$65.00
Rate for Payer: Brighton Health Commercial	$97.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$104.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.40
Rate for Payer: Group Health Inc Commercial	$65.00
Rate for Payer: Group Health Inc Medicare	$45.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.00
Rate for Payer: Hamaspik Choice Inc Medicare	$65.00

WIRE BASKET FOR KAIRISON SHAFTS

Facility

$1,394.00

Hospital Charge Code	40209546
Hospital Revenue Code	270
Min. Negotiated Rate	$487.90
Max. Negotiated Rate	$1,115.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$766.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$697.00
Rate for Payer: Aetna Government	$697.00
Rate for Payer: Brighton Health Commercial	$1,045.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,115.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$947.92
Rate for Payer: Group Health Inc Commercial	$697.00
Rate for Payer: Group Health Inc Medicare	$487.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$697.00
Rate for Payer: Hamaspik Choice Inc Medicare	$697.00

WIRE BOLTS

Facility

$532.50

Hospital Charge Code	64906018
Hospital Revenue Code	270
Min. Negotiated Rate	$186.38
Max. Negotiated Rate	$426.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$292.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$266.25
Rate for Payer: Aetna Government	$266.25
Rate for Payer: Brighton Health Commercial	$399.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$426.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$362.10
Rate for Payer: Group Health Inc Commercial	$266.25
Rate for Payer: Group Health Inc Medicare	$186.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$266.25
Rate for Payer: Hamaspik Choice Inc Medicare	$266.25

WIRE CANNULATED .8MM

Facility

$58.75

Hospital Charge Code	64905052
Hospital Revenue Code	270
Min. Negotiated Rate	$20.56
Max. Negotiated Rate	$47.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.38
Rate for Payer: Aetna Government	$29.38
Rate for Payer: Brighton Health Commercial	$44.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.95
Rate for Payer: Group Health Inc Commercial	$29.38
Rate for Payer: Group Health Inc Medicare	$20.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.38
Rate for Payer: Hamaspik Choice Inc Medicare	$29.38

WIRE COPE MANDRIL

Facility

$58.68

Hospital Charge Code	64903156
Hospital Revenue Code	270
Min. Negotiated Rate	$20.54
Max. Negotiated Rate	$46.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.34
Rate for Payer: Aetna Government	$29.34
Rate for Payer: Brighton Health Commercial	$44.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.90
Rate for Payer: Group Health Inc Commercial	$29.34
Rate for Payer: Group Health Inc Medicare	$20.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.34
Rate for Payer: Hamaspik Choice Inc Medicare	$29.34

WIRE FIXATION KIRSCHNER 0.9MM

Facility

$90.00

Hospital Charge Code	64905973
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: Brighton Health Commercial	$67.50
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

WIRE GD NCB-PH 1.6MMX190MM THR TP

Facility

$70.00

Service Code	HCPCS C1769
Hospital Charge Code	40204572
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$56.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$52.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.60
Rate for Payer: Group Health Inc Commercial	$35.00
Rate for Payer: Group Health Inc Medicare	$24.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.00
Rate for Payer: Hamaspik Choice Inc Medicare	$35.00

WIRE GLIDE .035 150CM FLEX ANG

Facility

$102.41

Hospital Charge Code	64902745
Hospital Revenue Code	270
Min. Negotiated Rate	$35.84
Max. Negotiated Rate	$81.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.20
Rate for Payer: Aetna Government	$51.20
Rate for Payer: Brighton Health Commercial	$76.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.64
Rate for Payer: Group Health Inc Commercial	$51.20
Rate for Payer: Group Health Inc Medicare	$35.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.20
Rate for Payer: Hamaspik Choice Inc Medicare	$51.20

WIRE GLIDE .038 150CM FLEX ANG

Facility

$147.50

Hospital Charge Code	64904545
Hospital Revenue Code	270
Min. Negotiated Rate	$51.62
Max. Negotiated Rate	$118.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.75
Rate for Payer: Aetna Government	$73.75
Rate for Payer: Brighton Health Commercial	$110.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$118.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$100.30
Rate for Payer: Group Health Inc Commercial	$73.75
Rate for Payer: Group Health Inc Medicare	$51.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.75
Rate for Payer: Hamaspik Choice Inc Medicare	$73.75

WIRE GLIDE .038 150CM FLEX STR

Facility

$100.05

Hospital Charge Code	64903020
Hospital Revenue Code	270
Min. Negotiated Rate	$35.02
Max. Negotiated Rate	$80.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.02
Rate for Payer: Aetna Government	$50.02
Rate for Payer: Brighton Health Commercial	$75.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.03
Rate for Payer: Group Health Inc Commercial	$50.02
Rate for Payer: Group Health Inc Medicare	$35.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.02
Rate for Payer: Hamaspik Choice Inc Medicare	$50.02

WIRE GUIDE .062 6 LONG

Facility

$80.00

Service Code	HCPCS C1769
Hospital Charge Code	64906865
Hospital Revenue Code	278
Min. Negotiated Rate	$40.00
Max. Negotiated Rate	$40.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00

WIRE GUIDE .062 6 LONG

Facility

$80.00

Service Code	HCPCS C1769
Hospital Charge Code	64906865
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$84.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$48.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.00
Rate for Payer: EmblemHealth Commercial	$40.00
Rate for Payer: Fidelis Medicare Advantage	$84.00
Rate for Payer: Group Health Inc Commercial	$40.00
Rate for Payer: Group Health Inc Medicare	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.00

WIRE GUIDE .090 X 47

Facility

$158.00

Service Code	HCPCS C1769
Hospital Charge Code	64906864
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$165.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$86.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$94.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$90.85
Rate for Payer: EmblemHealth Commercial	$79.00
Rate for Payer: Fidelis Medicare Advantage	$165.90
Rate for Payer: Group Health Inc Commercial	$79.00
Rate for Payer: Group Health Inc Medicare	$55.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.00
Rate for Payer: Hamaspik Choice Inc Medicare	$79.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$102.70

WIRE GUIDE .090 X 47

Facility

$158.00

Service Code	HCPCS C1769
Hospital Charge Code	64906864
Hospital Revenue Code	278
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$79.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.00
Rate for Payer: Hamaspik Choice Inc Medicare	$79.00

WIRE,GUIDE 1.6MMX190MM THREAD TIP

Facility

$44.50

Service Code	HCPCS C1769
Hospital Charge Code	40006598
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$35.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$33.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.26
Rate for Payer: Group Health Inc Commercial	$22.25
Rate for Payer: Group Health Inc Medicare	$15.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.25
Rate for Payer: Hamaspik Choice Inc Medicare	$22.25

Know your out-of-pocket cost for care.

All Charges