St. Barnabas Hospital

All Charges

Charge

Type

Price

5% LACTATED RINGERS - 500CC

Facility OP

$9.92

Hospital Charge Code	40193511
Hospital Revenue Code	710
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$7.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.96
Rate for Payer: Aetna Government	$4.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.75
Rate for Payer: Group Health Inc Commercial	$4.96
Rate for Payer: Group Health Inc Medicare	$3.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.96
Rate for Payer: Hamaspik Choice Inc Medicare	$4.96

5% LACTATED RINGERS -500 CC

Facility OP

$11.70

Hospital Charge Code	40503511
Hospital Revenue Code	260
Min. Negotiated Rate	$4.10
Max. Negotiated Rate	$9.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.85
Rate for Payer: Aetna Government	$5.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.96
Rate for Payer: Group Health Inc Commercial	$5.85
Rate for Payer: Group Health Inc Medicare	$4.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.85
Rate for Payer: Hamaspik Choice Inc Medicare	$5.85

5% MANNITOL IN WATER-1000CC

Facility OP

$34.38

Hospital Charge Code	40501700
Hospital Revenue Code	260
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$27.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.19
Rate for Payer: Aetna Government	$17.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.38
Rate for Payer: Group Health Inc Commercial	$17.19
Rate for Payer: Group Health Inc Medicare	$12.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.19
Rate for Payer: Hamaspik Choice Inc Medicare	$17.19

5MM HEX CANN DRIVER END CAP

Facility IP

$352.00

Service Code	HCPCS C1713
Hospital Charge Code	40006154
Hospital Revenue Code	278
Min. Negotiated Rate	$176.00
Max. Negotiated Rate	$176.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$176.00
Rate for Payer: Hamaspik Choice Inc Medicare	$176.00

5MM HEX CANN DRIVER END CAP

Facility OP

$352.00

Service Code	HCPCS C1713
Hospital Charge Code	40006154
Hospital Revenue Code	278
Min. Negotiated Rate	$123.20
Max. Negotiated Rate	$369.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$193.60
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	$176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$202.40
Rate for Payer: Fidelis Medicare Advantage	$369.60
Rate for Payer: Group Health Inc Commercial	$176.00
Rate for Payer: Group Health Inc Medicare	$123.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$176.00
Rate for Payer: Hamaspik Choice Inc Medicare	$176.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$228.80

5MM HEX DRIVER END CAP

Facility IP

$1,040.00

Service Code	HCPCS C1713
Hospital Charge Code	40006153
Hospital Revenue Code	278
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$520.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$520.00
Rate for Payer: Hamaspik Choice Inc Medicare	$520.00

5MM HEX DRIVER END CAP

Facility OP

$1,040.00

Service Code	HCPCS C1713
Hospital Charge Code	40006153
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,092.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$572.00
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	$520.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$598.00
Rate for Payer: Fidelis Medicare Advantage	$1,092.00
Rate for Payer: Group Health Inc Commercial	$520.00
Rate for Payer: Group Health Inc Medicare	$364.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$520.00
Rate for Payer: Hamaspik Choice Inc Medicare	$520.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$676.00

5MM HEX DRIVER SET SCREW

Facility IP

$1,376.00

Service Code	HCPCS C1713
Hospital Charge Code	40006137
Hospital Revenue Code	278
Min. Negotiated Rate	$688.00
Max. Negotiated Rate	$688.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00
Rate for Payer: Hamaspik Choice Inc Medicare	$688.00

5MM HEX DRIVER SET SCREW

Facility OP

$1,376.00

Service Code	HCPCS C1713
Hospital Charge Code	40006137
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,444.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.80
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	$688.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$791.20
Rate for Payer: Fidelis Medicare Advantage	$1,444.80
Rate for Payer: Group Health Inc Commercial	$688.00
Rate for Payer: Group Health Inc Medicare	$481.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00
Rate for Payer: Hamaspik Choice Inc Medicare	$688.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$894.40

5MM PIN DRIVER

Facility OP

$227.00

Hospital Charge Code	40200638
Hospital Revenue Code	270
Min. Negotiated Rate	$79.45
Max. Negotiated Rate	$181.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$124.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$113.50
Rate for Payer: Aetna Government	$113.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$181.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$154.36
Rate for Payer: Group Health Inc Commercial	$113.50
Rate for Payer: Group Health Inc Medicare	$79.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.50
Rate for Payer: Hamaspik Choice Inc Medicare	$113.50

5MM PRE-DRILLING ASSEMBLY-LONG

Facility IP

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40200553
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

5MM PRE-DRILLING ASSEMBLY-LONG

Facility OP

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40200553
Hospital Revenue Code	278
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$300.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.30
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	$143.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.45
Rate for Payer: Fidelis Medicare Advantage	$300.30
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.90

5MM PRE-DRILLING ASSEMBLY-SHORT

Facility IP

$182.00

Service Code	HCPCS C1713
Hospital Charge Code	40200554
Hospital Revenue Code	278
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.00
Rate for Payer: Hamaspik Choice Inc Medicare	$91.00

5MM PRE-DRILLING ASSEMBLY-SHORT

Facility OP

$182.00

Service Code	HCPCS C1713
Hospital Charge Code	40200554
Hospital Revenue Code	278
Min. Negotiated Rate	$63.70
Max. Negotiated Rate	$191.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$100.10
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	$91.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$104.65
Rate for Payer: Fidelis Medicare Advantage	$191.10
Rate for Payer: Group Health Inc Commercial	$91.00
Rate for Payer: Group Health Inc Medicare	$63.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.00
Rate for Payer: Hamaspik Choice Inc Medicare	$91.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$118.30

5 PRONGED MANIFOLD

Facility OP

$6.03

Hospital Charge Code	42905235
Hospital Revenue Code	801
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$4.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.02
Rate for Payer: Aetna Government	$3.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.10
Rate for Payer: Group Health Inc Commercial	$3.02
Rate for Payer: Group Health Inc Medicare	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.02
Rate for Payer: Hamaspik Choice Inc Medicare	$3.02

5% SODIUM BICARBONATE 500CC

Facility OP

$23.04

Hospital Charge Code	40504981
Hospital Revenue Code	260
Min. Negotiated Rate	$8.06
Max. Negotiated Rate	$18.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.52
Rate for Payer: Aetna Government	$11.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.67
Rate for Payer: Group Health Inc Commercial	$11.52
Rate for Payer: Group Health Inc Medicare	$8.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.52
Rate for Payer: Hamaspik Choice Inc Medicare	$11.52

5X115MM FULLY THREADED

Facility IP

$266.00

Service Code	HCPCS C1713
Hospital Charge Code	40200550
Hospital Revenue Code	278
Min. Negotiated Rate	$133.00
Max. Negotiated Rate	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.00
Rate for Payer: Hamaspik Choice Inc Medicare	$133.00

5X115MM FULLY THREADED

Facility OP

$266.00

Service Code	HCPCS C1713
Hospital Charge Code	40200550
Hospital Revenue Code	278
Min. Negotiated Rate	$93.10
Max. Negotiated Rate	$279.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.30
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	$133.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$152.95
Rate for Payer: Fidelis Medicare Advantage	$279.30
Rate for Payer: Group Health Inc Commercial	$133.00
Rate for Payer: Group Health Inc Medicare	$93.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.00
Rate for Payer: Hamaspik Choice Inc Medicare	$133.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$172.90

5X120X35MM SLFDRILLING/SLFTAPPING

Facility OP

$225.40

Service Code	HCPCS C1713
Hospital Charge Code	40200551
Hospital Revenue Code	278
Min. Negotiated Rate	$78.89
Max. Negotiated Rate	$236.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.97
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	$112.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.60
Rate for Payer: Fidelis Medicare Advantage	$236.67
Rate for Payer: Group Health Inc Commercial	$112.70
Rate for Payer: Group Health Inc Medicare	$78.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.70
Rate for Payer: Hamaspik Choice Inc Medicare	$112.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$146.51

5X120X35MM SLFDRILLING/SLFTAPPING

Facility IP

$225.40

Service Code	HCPCS C1713
Hospital Charge Code	40200551
Hospital Revenue Code	278
Min. Negotiated Rate	$112.70
Max. Negotiated Rate	$112.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.70
Rate for Payer: Hamaspik Choice Inc Medicare	$112.70

60MM PARTIAL THREAD

Facility OP

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40200558
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$315.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
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	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

60MM PARTIAL THREAD

Facility IP

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40200558
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

6% DEXTRAN-75NS 500CC

Facility OP

$48.55

Hospital Charge Code	40509601
Hospital Revenue Code	260
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: 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

6F GLIDESHEATH

Facility OP

$213.00

Hospital Charge Code	66526891
Hospital Revenue Code	270
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$170.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$117.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$106.50
Rate for Payer: Aetna Government	$106.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.84
Rate for Payer: Group Health Inc Commercial	$106.50
Rate for Payer: Group Health Inc Medicare	$74.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.50
Rate for Payer: Hamaspik Choice Inc Medicare	$106.50

6H 2.3MM COMPRESSION PLATE

Facility IP

$728.00

Service Code	HCPCS C1713
Hospital Charge Code	40202259
Hospital Revenue Code	278
Min. Negotiated Rate	$364.00
Max. Negotiated Rate	$364.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$364.00
Rate for Payer: Hamaspik Choice Inc Medicare	$364.00

Price Transparency.

All Charges