St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Y-PLATE

Facility

$1,987.50

Service Code	HCPCS C1713
Hospital Charge Code	64907244
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$993.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$993.75
Rate for Payer: Hamaspik Choice Inc Medicare	$993.75

YUKON SCREW POLY STRY

Facility

$11,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64906986
Hospital Revenue Code	278
Min. Negotiated Rate	$5,737.50
Max. Negotiated Rate	$5,737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,737.50

YUKON SCREW POLY STRY

Facility

$11,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64906986
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$12,048.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,311.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,885.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,737.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,598.12
Rate for Payer: EmblemHealth Commercial	$5,737.50
Rate for Payer: Fidelis Medicare Advantage	$12,048.75
Rate for Payer: Group Health Inc Commercial	$5,737.50
Rate for Payer: Group Health Inc Medicare	$4,016.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,737.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,458.75

Z BALLOON/UT/DIAMOND 7X2X120

Facility

$612.36

Service Code	HCPCS C1725
Hospital Charge Code	41569691
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$642.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$336.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$367.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$306.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$352.11
Rate for Payer: EmblemHealth Commercial	$306.18
Rate for Payer: Fidelis Medicare Advantage	$642.98
Rate for Payer: Group Health Inc Commercial	$306.18
Rate for Payer: Group Health Inc Medicare	$214.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$306.18
Rate for Payer: Hamaspik Choice Inc Medicare	$306.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$398.03

Z BALLOON/UT/DIAMOND 7X2X120

Facility

$612.36

Service Code	HCPCS C1725
Hospital Charge Code	41569691
Hospital Revenue Code	278
Min. Negotiated Rate	$306.18
Max. Negotiated Rate	$306.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$306.18
Rate for Payer: Hamaspik Choice Inc Medicare	$306.18

Z CATH COBRA 3 5FR 035-65 CM

Facility

$56.00

Service Code	HCPCS C1725
Hospital Charge Code	41569732
Hospital Revenue Code	278
Min. Negotiated Rate	$19.60
Max. Negotiated Rate	$58.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$33.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.20
Rate for Payer: EmblemHealth Commercial	$28.00
Rate for Payer: Fidelis Medicare Advantage	$58.80
Rate for Payer: Group Health Inc Commercial	$28.00
Rate for Payer: Group Health Inc Medicare	$19.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.00
Rate for Payer: Hamaspik Choice Inc Medicare	$28.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.40

Z CATH COBRA 3 5FR 035-65 CM

Facility

$56.00

Service Code	HCPCS C1725
Hospital Charge Code	41569732
Hospital Revenue Code	278
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.00
Rate for Payer: Hamaspik Choice Inc Medicare	$28.00

ZENITH FLEX GRAFT MAIN BODY

Facility

$21,780.00

Service Code	HCPCS C1768
Hospital Charge Code	64904951
Hospital Revenue Code	278
Min. Negotiated Rate	$10,890.00
Max. Negotiated Rate	$10,890.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$10,890.00
Rate for Payer: Hamaspik Choice Inc Medicare	$10,890.00

ZENITH FLEX GRAFT MAIN BODY

Facility

$21,780.00

Service Code	HCPCS C1768
Hospital Charge Code	64904951
Hospital Revenue Code	278
Min. Negotiated Rate	$322.77
Max. Negotiated Rate	$22,869.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11,979.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$322.77
Rate for Payer: Aetna Government	$322.77
Rate for Payer: Brighton Health Commercial	$13,068.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10,890.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$12,523.50
Rate for Payer: EmblemHealth Commercial	$10,890.00
Rate for Payer: Fidelis Medicare Advantage	$22,869.00
Rate for Payer: Group Health Inc Commercial	$10,890.00
Rate for Payer: Group Health Inc Medicare	$7,623.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$10,890.00
Rate for Payer: Hamaspik Choice Inc Medicare	$10,890.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14,157.00

ZENITH SPIRAL Z ILC LEG GRAFT A

Facility

$7,945.00

Service Code	HCPCS C1768
Hospital Charge Code	64906039
Hospital Revenue Code	278
Min. Negotiated Rate	$322.77
Max. Negotiated Rate	$8,342.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,369.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$322.77
Rate for Payer: Aetna Government	$322.77
Rate for Payer: Brighton Health Commercial	$4,767.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,972.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,568.38
Rate for Payer: EmblemHealth Commercial	$3,972.50
Rate for Payer: Fidelis Medicare Advantage	$8,342.25
Rate for Payer: Group Health Inc Commercial	$3,972.50
Rate for Payer: Group Health Inc Medicare	$2,780.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,972.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,972.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,164.25

ZENITH SPIRAL Z ILC LEG GRAFT A

Facility

$7,945.00

Service Code	HCPCS C1768
Hospital Charge Code	64906039
Hospital Revenue Code	278
Min. Negotiated Rate	$3,972.50
Max. Negotiated Rate	$3,972.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,972.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,972.50

ZENITH SPIRAL Z ILC LEG GRAFT B

Facility

$7,945.00

Service Code	HCPCS C1768
Hospital Charge Code	64906040
Hospital Revenue Code	278
Min. Negotiated Rate	$322.77
Max. Negotiated Rate	$8,342.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,369.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$322.77
Rate for Payer: Aetna Government	$322.77
Rate for Payer: Brighton Health Commercial	$4,767.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,972.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,568.38
Rate for Payer: EmblemHealth Commercial	$3,972.50
Rate for Payer: Fidelis Medicare Advantage	$8,342.25
Rate for Payer: Group Health Inc Commercial	$3,972.50
Rate for Payer: Group Health Inc Medicare	$2,780.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,972.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,972.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,164.25

ZENITH SPIRAL Z ILC LEG GRAFT B

Facility

$7,945.00

Service Code	HCPCS C1768
Hospital Charge Code	64906040
Hospital Revenue Code	278
Min. Negotiated Rate	$3,972.50
Max. Negotiated Rate	$3,972.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,972.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,972.50

ZEPHEROR

Facility

$6.73

Hospital Charge Code	40207590
Hospital Revenue Code	270
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.36
Rate for Payer: Aetna Government	$3.36
Rate for Payer: Brighton Health Commercial	$5.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.36
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.36
Rate for Payer: Hamaspik Choice Inc Medicare	$3.36

Zeroform Dressing

Facility

$4.25

Hospital Charge Code	40207500
Hospital Revenue Code	270
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$3.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.12
Rate for Payer: Aetna Government	$2.12
Rate for Payer: Brighton Health Commercial	$3.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.89
Rate for Payer: Group Health Inc Commercial	$2.12
Rate for Payer: Group Health Inc Medicare	$1.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2.12

ZICKEL NAIL

Facility

$360.76

Hospital Charge Code	40207024
Hospital Revenue Code	270
Min. Negotiated Rate	$126.27
Max. Negotiated Rate	$288.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$198.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.38
Rate for Payer: Aetna Government	$180.38
Rate for Payer: Brighton Health Commercial	$270.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$288.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$245.32
Rate for Payer: Group Health Inc Commercial	$180.38
Rate for Payer: Group Health Inc Medicare	$126.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$180.38
Rate for Payer: Hamaspik Choice Inc Medicare	$180.38

ZICKEL ROD

Facility

$1,713.76

Hospital Charge Code	40207023
Hospital Revenue Code	270
Min. Negotiated Rate	$599.82
Max. Negotiated Rate	$1,371.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$942.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$856.88
Rate for Payer: Aetna Government	$856.88
Rate for Payer: Brighton Health Commercial	$1,285.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,371.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,165.36
Rate for Payer: Group Health Inc Commercial	$856.88
Rate for Payer: Group Health Inc Medicare	$599.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$856.88
Rate for Payer: Hamaspik Choice Inc Medicare	$856.88

ZICKEL SCREW

Facility

$258.70

Hospital Charge Code	40207025
Hospital Revenue Code	270
Min. Negotiated Rate	$90.54
Max. Negotiated Rate	$206.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$142.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$129.35
Rate for Payer: Aetna Government	$129.35
Rate for Payer: Brighton Health Commercial	$194.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$175.92
Rate for Payer: Group Health Inc Commercial	$129.35
Rate for Payer: Group Health Inc Medicare	$90.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$129.35
Rate for Payer: Hamaspik Choice Inc Medicare	$129.35

ZIDOVUDINE 100 MG CAP

Facility

$2.50

Hospital Charge Code	41651805
Hospital Revenue Code	250
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$2.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.25
Rate for Payer: Aetna Government	$1.25
Rate for Payer: Brighton Health Commercial	$1.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.70
Rate for Payer: Group Health Inc Commercial	$1.25
Rate for Payer: Group Health Inc Medicare	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.62

ZIDOVUDINE 100 MG CAP

Facility

$2.50

Hospital Charge Code	41641805
Hospital Revenue Code	250
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$2.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.25
Rate for Payer: Aetna Government	$1.25
Rate for Payer: Brighton Health Commercial	$1.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.70
Rate for Payer: Group Health Inc Commercial	$1.25
Rate for Payer: Group Health Inc Medicare	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.62

ZIDOVUDINE 100 MG PO CAPS [11692]

Facility

$2.02

Service Code	NDC 65862010701
Hospital Charge Code	65862010701
Hospital Revenue Code	250
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$1.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.01
Rate for Payer: Aetna Government	$1.01
Rate for Payer: Brighton Health Commercial	$1.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.37
Rate for Payer: Group Health Inc Commercial	$1.01
Rate for Payer: Group Health Inc Medicare	$0.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.01
Rate for Payer: Hamaspik Choice Inc Medicare	$1.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.31

ZIDOVUDINE 10 MG/ML INJ

Facility

$2.89

Service Code	HCPCS J3485
Hospital Charge Code	41641806
Hospital Revenue Code	636
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.51
Rate for Payer: Aetna Government	$1.51
Rate for Payer: Brighton Health Commercial	$1.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.66
Rate for Payer: Group Health Inc Commercial	$1.44
Rate for Payer: Group Health Inc Medicare	$1.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.60
Rate for Payer: SOMOS Essential	$1.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.88

ZIDOVUDINE 10 MG/ML INJ

Facility

$2.89

Service Code	HCPCS J3485
Hospital Charge Code	41651806
Hospital Revenue Code	636
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.51
Rate for Payer: Aetna Government	$1.51
Rate for Payer: Brighton Health Commercial	$1.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.66
Rate for Payer: Group Health Inc Commercial	$1.44
Rate for Payer: Group Health Inc Medicare	$1.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.60
Rate for Payer: SOMOS Essential	$1.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.88

ZIDOVUDINE 10 MG/ML INJ

Facility

$2.89

Service Code	HCPCS J3485
Hospital Charge Code	41641806
Hospital Revenue Code	636
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1.44

ZIDOVUDINE 10 MG/ML INJ

Facility

$2.89

Service Code	HCPCS J3485
Hospital Charge Code	41651806
Hospital Revenue Code	636
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1.44

Know your out-of-pocket cost for care.

All Charges