St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

WRENDR KIT

Facility

$90.00

Hospital Charge Code	40203006
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

WRIGHT ANCHORLOCK LEADING EDGE SO

Facility

$790.00

Hospital Charge Code	40009338
Hospital Revenue Code	272
Min. Negotiated Rate	$276.50
Max. Negotiated Rate	$632.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$434.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$395.00
Rate for Payer: Aetna Government	$395.00
Rate for Payer: Brighton Health Commercial	$592.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$632.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$537.20
Rate for Payer: Group Health Inc Commercial	$395.00
Rate for Payer: Group Health Inc Medicare	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00

WRIGHT ANCHORLOCK LEADING EDGE SO

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	40203355
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$829.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$434.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$474.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$395.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$454.25
Rate for Payer: EmblemHealth Commercial	$395.00
Rate for Payer: Fidelis Medicare Advantage	$829.50
Rate for Payer: Group Health Inc Commercial	$395.00
Rate for Payer: Group Health Inc Medicare	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$513.50

WRIGHT ANCHORLOCK LEADING EDGE SO

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	40203355
Hospital Revenue Code	278
Min. Negotiated Rate	$395.00
Max. Negotiated Rate	$395.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00

WRIGHT PELLETS OSTEOSET BONE FILL

Facility

$1,310.00

Service Code	HCPCS C1713
Hospital Charge Code	40203356
Hospital Revenue Code	278
Min. Negotiated Rate	$655.00
Max. Negotiated Rate	$655.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$655.00
Rate for Payer: Hamaspik Choice Inc Medicare	$655.00

WRIGHT PELLETS OSTEOSET BONE FILL

Facility

$1,310.00

Hospital Charge Code	40009339
Hospital Revenue Code	272
Min. Negotiated Rate	$458.50
Max. Negotiated Rate	$1,048.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$720.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$655.00
Rate for Payer: Aetna Government	$655.00
Rate for Payer: Brighton Health Commercial	$982.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,048.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$890.80
Rate for Payer: Group Health Inc Commercial	$655.00
Rate for Payer: Group Health Inc Medicare	$458.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$655.00
Rate for Payer: Hamaspik Choice Inc Medicare	$655.00

WRIGHT PELLETS OSTEOSET BONE FILL

Facility

$1,310.00

Service Code	HCPCS C1713
Hospital Charge Code	40203356
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,375.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$720.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$786.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$655.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$753.25
Rate for Payer: EmblemHealth Commercial	$655.00
Rate for Payer: Fidelis Medicare Advantage	$1,375.50
Rate for Payer: Group Health Inc Commercial	$655.00
Rate for Payer: Group Health Inc Medicare	$458.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$655.00
Rate for Payer: Hamaspik Choice Inc Medicare	$655.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$851.50

WRIGHT ROD TENDON

Facility

$4,930.00

Service Code	HCPCS C1713
Hospital Charge Code	64907025
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,176.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,711.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,958.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,465.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,834.75
Rate for Payer: EmblemHealth Commercial	$2,465.00
Rate for Payer: Fidelis Medicare Advantage	$5,176.50
Rate for Payer: Group Health Inc Commercial	$2,465.00
Rate for Payer: Group Health Inc Medicare	$1,725.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,465.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,465.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,204.50

WRIGHT ROD TENDON

Facility

$4,930.00

Service Code	HCPCS C1713
Hospital Charge Code	64907025
Hospital Revenue Code	278
Min. Negotiated Rate	$2,465.00
Max. Negotiated Rate	$2,465.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,465.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,465.00

WRIGHT STAIN

Facility

$10.68

Service Code	HCPCS 87205
Hospital Charge Code	40614100
Hospital Revenue Code	306
Rate for Payer: Cash Price	$4.27

WRIGHT STAIN

Facility

$10.68

Service Code	HCPCS 87205
Hospital Charge Code	40614100
Hospital Revenue Code	306
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$8.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.27
Rate for Payer: Aetna Government	$4.27
Rate for Payer: Brighton Health Commercial	$8.01
Rate for Payer: Cash Price	$4.27
Rate for Payer: Cash Price	$4.27
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.74
Rate for Payer: Elderplan Medicare Advantage	$4.27
Rate for Payer: EmblemHealth Commercial	$4.27
Rate for Payer: Fidelis Essential Plan Aliesa	$3.63
Rate for Payer: Fidelis Essential Plan QHP	$3.80
Rate for Payer: Fidelis Medicare Advantage	$4.27
Rate for Payer: Fidelis Qualified Health Plan	$3.80
Rate for Payer: Group Health Inc Commercial	$4.27
Rate for Payer: Group Health Inc Medicare	$4.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.34
Rate for Payer: Hamaspik Choice Inc Medicare	$4.27
Rate for Payer: Healthfirst Medicare Advantage	$4.27
Rate for Payer: Healthfirst QHP	$4.27
Rate for Payer: Senior Whole Health Medicare Advantage	$4.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.42
Rate for Payer: Wellcare Medicare	$3.84

WRIST ENDOSCOPY W RELEASE OF LIGA

Facility

$4,105.13

Service Code	HCPCS 29848
Hospital Charge Code	40024269
Hospital Revenue Code	360
Rate for Payer: Cash Price	$1,858.61

WRIST ENDOSCOPY W RELEASE OF LIGA

Facility

$4,105.13

Service Code	HCPCS 29848
Hospital Charge Code	40024269
Hospital Revenue Code	360
Min. Negotiated Rate	$1,486.89
Max. Negotiated Rate	$5,593.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,593.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,858.61
Rate for Payer: Aetna Government	$1,858.61
Rate for Payer: Brighton Health Commercial	$3,078.85
Rate for Payer: Cash Price	$1,858.61
Rate for Payer: Cash Price	$1,858.61
Rate for Payer: Cash Price	$1,858.61
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,858.61
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	$1,858.61
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,579.82
Rate for Payer: Fidelis Essential Plan QHP	$1,654.16
Rate for Payer: Fidelis Medicare Advantage	$1,858.61
Rate for Payer: Fidelis Qualified Health Plan	$1,654.16
Rate for Payer: Group Health Inc Commercial	$1,858.61
Rate for Payer: Group Health Inc Medicare	$1,858.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,052.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1,858.61
Rate for Payer: Healthfirst Medicare Advantage	$1,579.82
Rate for Payer: Healthfirst QHP	$1,858.61
Rate for Payer: Senior Whole Health Medicare Advantage	$1,858.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,858.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,486.89
Rate for Payer: Wellcare Medicare	$1,765.68

Wrist Forearm Splint

Facility

$48.55

Hospital Charge Code	40206950
Hospital Revenue Code	270
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$38.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.28
Rate for Payer: Aetna Government	$24.28
Rate for Payer: Brighton Health Commercial	$36.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.01
Rate for Payer: Group Health Inc Commercial	$24.28
Rate for Payer: Group Health Inc Medicare	$16.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.28
Rate for Payer: Hamaspik Choice Inc Medicare	$24.28

WRISTJACK FRAC RED SYS TRAY

Facility

$2,710.00

Hospital Charge Code	40202387
Hospital Revenue Code	270
Min. Negotiated Rate	$948.50
Max. Negotiated Rate	$2,168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,490.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,355.00
Rate for Payer: Aetna Government	$1,355.00
Rate for Payer: Brighton Health Commercial	$2,032.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,842.80
Rate for Payer: Group Health Inc Commercial	$1,355.00
Rate for Payer: Group Health Inc Medicare	$948.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,355.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,355.00

WRIST RESTRAINT

Facility

$63.43

Hospital Charge Code	40206940
Hospital Revenue Code	270
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$50.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.72
Rate for Payer: Aetna Government	$31.72
Rate for Payer: Brighton Health Commercial	$47.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.13
Rate for Payer: Group Health Inc Commercial	$31.72
Rate for Payer: Group Health Inc Medicare	$22.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.72
Rate for Payer: Hamaspik Choice Inc Medicare	$31.72

WRIST STRAPPING

Facility

$101.25

Service Code	HCPCS 29260
Hospital Charge Code	30101324
Hospital Revenue Code	450
Rate for Payer: Cash Price	$70.74

WRIST STRAPPING

Facility

$101.25

Service Code	HCPCS 29260
Hospital Charge Code	30101324
Hospital Revenue Code	450
Min. Negotiated Rate	$50.62
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.74
Rate for Payer: Aetna Government	$70.74
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$70.74
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$70.74
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	$70.74
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$60.13
Rate for Payer: Fidelis Essential Plan QHP	$62.96
Rate for Payer: Fidelis Medicare Advantage	$70.74
Rate for Payer: Fidelis Qualified Health Plan	$62.96
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	$50.62
Rate for Payer: Hamaspik Choice Inc Medicare	$70.74
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$70.74
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$70.74
Rate for Payer: Senior Whole Health Medicare Advantage	$70.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$56.59
Rate for Payer: Wellcare Medicare	$67.20

WS QLTD XXL ADULT BRIEFS 65-78

Facility

$1.33

Hospital Charge Code	64902231
Hospital Revenue Code	270
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$1.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.67
Rate for Payer: Aetna Government	$0.67
Rate for Payer: Brighton Health Commercial	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.90
Rate for Payer: Group Health Inc Commercial	$0.67
Rate for Payer: Group Health Inc Medicare	$0.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.67
Rate for Payer: Hamaspik Choice Inc Medicare	$0.67

WYDASE

Facility

$12.05

Hospital Charge Code	40206960
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$9.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.02
Rate for Payer: Aetna Government	$6.02
Rate for Payer: Brighton Health Commercial	$9.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.19
Rate for Payer: Group Health Inc Commercial	$6.02
Rate for Payer: Group Health Inc Medicare	$4.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.02
Rate for Payer: Hamaspik Choice Inc Medicare	$6.02

XC MINI ENDCAP, 15X12MM P 12

Facility

$3,927.00

Hospital Charge Code	64905580
Hospital Revenue Code	270
Min. Negotiated Rate	$1,374.45
Max. Negotiated Rate	$3,141.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,159.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,963.50
Rate for Payer: Aetna Government	$1,963.50
Rate for Payer: Brighton Health Commercial	$2,945.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,141.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,670.36
Rate for Payer: Group Health Inc Commercial	$1,963.50
Rate for Payer: Group Health Inc Medicare	$1,374.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,963.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,963.50

X-CORE MINI CORE, 12MM 25-40MM

Facility

$16,189.20

Hospital Charge Code	64905579
Hospital Revenue Code	279
Min. Negotiated Rate	$5,666.22
Max. Negotiated Rate	$12,951.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8,904.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8,094.60
Rate for Payer: Aetna Government	$8,094.60
Rate for Payer: Brighton Health Commercial	$12,141.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12,951.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$11,008.66
Rate for Payer: Group Health Inc Commercial	$8,094.60
Rate for Payer: Group Health Inc Medicare	$5,666.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,094.60
Rate for Payer: Hamaspik Choice Inc Medicare	$8,094.60

XFUSE XLG 0 DEGREES

Facility

$2,050.00

Service Code	HCPCS C1776
Hospital Charge Code	40208113
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,152.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,127.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,230.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,025.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,178.75
Rate for Payer: EmblemHealth Commercial	$1,025.00
Rate for Payer: Fidelis Medicare Advantage	$2,152.50
Rate for Payer: Group Health Inc Commercial	$1,025.00
Rate for Payer: Group Health Inc Medicare	$717.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,025.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,025.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,332.50

XFUSE XLG 0 DEGREES

Facility

$2,050.00

Service Code	HCPCS C1776
Hospital Charge Code	40208113
Hospital Revenue Code	278
Min. Negotiated Rate	$1,025.00
Max. Negotiated Rate	$1,025.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,025.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,025.00

XGEVA 120MG - 1MG

Facility

$28.15

Service Code	HCPCS J0897
Hospital Charge Code	41645658
Hospital Revenue Code	636
Min. Negotiated Rate	$14.08
Max. Negotiated Rate	$14.08
Rate for Payer: Cash Price	$25.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.08
Rate for Payer: Hamaspik Choice Inc Medicare	$14.08

Know your out-of-pocket cost for care.

All Charges