St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ MEDITECH WALLGRAFT 70/507

Facility

$6,378.75

Service Code	HCPCS C1876
Hospital Charge Code	41569546
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$6,697.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,508.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$3,827.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,189.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,667.78
Rate for Payer: EmblemHealth Commercial	$3,189.38
Rate for Payer: Fidelis Medicare Advantage	$6,697.69
Rate for Payer: Group Health Inc Commercial	$3,189.38
Rate for Payer: Group Health Inc Medicare	$2,232.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,189.38
Rate for Payer: Hamaspik Choice Inc Medicare	$3,189.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,146.19

ZZ MEDITECH WALLGRAFT 70/507

Facility

$6,378.75

Service Code	HCPCS C1876
Hospital Charge Code	41569546
Hospital Revenue Code	278
Min. Negotiated Rate	$3,189.38
Max. Negotiated Rate	$3,189.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,189.38
Rate for Payer: Hamaspik Choice Inc Medicare	$3,189.38

ZZ MEDITECH WALLGRAFT 70/575

Facility

$5,528.25

Service Code	HCPCS C1876
Hospital Charge Code	41569544
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$5,804.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,040.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$3,316.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,764.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,178.74
Rate for Payer: EmblemHealth Commercial	$2,764.12
Rate for Payer: Fidelis Medicare Advantage	$5,804.66
Rate for Payer: Group Health Inc Commercial	$2,764.12
Rate for Payer: Group Health Inc Medicare	$1,934.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,764.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,593.36

ZZ MEDITECH WALLGRAFT 70/575

Facility

$5,528.25

Service Code	HCPCS C1876
Hospital Charge Code	41569544
Hospital Revenue Code	278
Min. Negotiated Rate	$2,764.12
Max. Negotiated Rate	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,764.12

ZZ MEDITECH WALLGRAFT 70/585

Facility

$5,528.25

Service Code	HCPCS C1876
Hospital Charge Code	41569545
Hospital Revenue Code	278
Min. Negotiated Rate	$2,764.12
Max. Negotiated Rate	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,764.12

ZZ MEDITECH WALLGRAFT 70/585

Facility

$5,528.25

Service Code	HCPCS C1876
Hospital Charge Code	41569545
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$5,804.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,040.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$3,316.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,764.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,178.74
Rate for Payer: EmblemHealth Commercial	$2,764.12
Rate for Payer: Fidelis Medicare Advantage	$5,804.66
Rate for Payer: Group Health Inc Commercial	$2,764.12
Rate for Payer: Group Health Inc Medicare	$1,934.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,764.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,593.36

ZZ MEDI WIRE KATZEN 35/145

Facility

$510.30

Hospital Charge Code	41569582
Hospital Revenue Code	270
Min. Negotiated Rate	$178.60
Max. Negotiated Rate	$408.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$280.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$255.15
Rate for Payer: Aetna Government	$255.15
Rate for Payer: Brighton Health Commercial	$382.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$408.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$347.00
Rate for Payer: Group Health Inc Commercial	$255.15
Rate for Payer: Group Health Inc Medicare	$178.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$255.15
Rate for Payer: Hamaspik Choice Inc Medicare	$255.15

ZZ MEDI WIRE TRNSEND 18

Facility

$467.78

Hospital Charge Code	41569579
Hospital Revenue Code	270
Min. Negotiated Rate	$163.72
Max. Negotiated Rate	$374.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$257.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$233.89
Rate for Payer: Aetna Government	$233.89
Rate for Payer: Brighton Health Commercial	$350.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$374.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$318.09
Rate for Payer: Group Health Inc Commercial	$233.89
Rate for Payer: Group Health Inc Medicare	$163.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.89
Rate for Payer: Hamaspik Choice Inc Medicare	$233.89

ZZ MEDI WIRE V-18 CONTRL

Facility

$269.33

Hospital Charge Code	41569580
Hospital Revenue Code	270
Min. Negotiated Rate	$94.27
Max. Negotiated Rate	$215.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.66
Rate for Payer: Aetna Government	$134.66
Rate for Payer: Brighton Health Commercial	$202.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$215.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.14
Rate for Payer: Group Health Inc Commercial	$134.66
Rate for Payer: Group Health Inc Medicare	$94.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$134.66
Rate for Payer: Hamaspik Choice Inc Medicare	$134.66

ZZ MEDLINE 1000ML PRESSURE INFUSE

Facility

$20.50

Hospital Charge Code	41566954
Hospital Revenue Code	272
Min. Negotiated Rate	$7.18
Max. Negotiated Rate	$16.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.25
Rate for Payer: Aetna Government	$10.25
Rate for Payer: Brighton Health Commercial	$15.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.94
Rate for Payer: Group Health Inc Commercial	$10.25
Rate for Payer: Group Health Inc Medicare	$7.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.25
Rate for Payer: Hamaspik Choice Inc Medicare	$10.25

ZZ MEDRAD ANGIOJET 6F/120CM

Facility

$3,460.00

Hospital Charge Code	41561957
Hospital Revenue Code	270
Min. Negotiated Rate	$1,211.00
Max. Negotiated Rate	$2,768.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,903.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,730.00
Rate for Payer: Aetna Government	$1,730.00
Rate for Payer: Brighton Health Commercial	$2,595.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,768.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,352.80
Rate for Payer: Group Health Inc Commercial	$1,730.00
Rate for Payer: Group Health Inc Medicare	$1,211.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,730.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,730.00

ZZ MEDTRONIC KYPHON BONE BX DEV

Facility

$280.00

Hospital Charge Code	41544800
Hospital Revenue Code	272
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$224.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$140.00
Rate for Payer: Aetna Government	$140.00
Rate for Payer: Brighton Health Commercial	$210.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$224.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$190.40
Rate for Payer: Group Health Inc Commercial	$140.00
Rate for Payer: Group Health Inc Medicare	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00

ZZ MEDTRONIC KYPHON BONE CEMENT/M

Facility

$210.00

Hospital Charge Code	41540601
Hospital Revenue Code	272
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.00
Rate for Payer: Aetna Government	$105.00
Rate for Payer: Brighton Health Commercial	$157.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.80
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00

ZZ MEDTRONIC KYPHON EXP CURETTE

Facility

$495.00

Hospital Charge Code	41540600
Hospital Revenue Code	272
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$396.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$247.50
Rate for Payer: Aetna Government	$247.50
Rate for Payer: Brighton Health Commercial	$371.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$396.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$336.60
Rate for Payer: Group Health Inc Commercial	$247.50
Rate for Payer: Group Health Inc Medicare	$173.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.50
Rate for Payer: Hamaspik Choice Inc Medicare	$247.50

ZZ MEDTRONIC KYPHON EXPRESS TRAY

Facility

$3,925.00

Hospital Charge Code	41540602
Hospital Revenue Code	272
Min. Negotiated Rate	$1,373.75
Max. Negotiated Rate	$3,140.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,158.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,962.50
Rate for Payer: Aetna Government	$1,962.50
Rate for Payer: Brighton Health Commercial	$2,943.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,140.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,669.00
Rate for Payer: Group Health Inc Commercial	$1,962.50
Rate for Payer: Group Health Inc Medicare	$1,373.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,962.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,962.50

ZZ MERIT DRAINAGE BAG

Facility

$21.00

Hospital Charge Code	41567758
Hospital Revenue Code	270
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$16.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.50
Rate for Payer: Aetna Government	$10.50
Rate for Payer: Brighton Health Commercial	$15.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.28
Rate for Payer: Group Health Inc Commercial	$10.50
Rate for Payer: Group Health Inc Medicare	$7.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.50
Rate for Payer: Hamaspik Choice Inc Medicare	$10.50

ZZ MERIT PICC LINE SUPPLIES

Facility

$126.00

Hospital Charge Code	41561350
Hospital Revenue Code	272
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$100.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.00
Rate for Payer: Aetna Government	$63.00
Rate for Payer: Brighton Health Commercial	$94.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.68
Rate for Payer: Group Health Inc Commercial	$63.00
Rate for Payer: Group Health Inc Medicare	$44.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.00
Rate for Payer: Hamaspik Choice Inc Medicare	$63.00

ZZ MERIT THORA/PARAC SET

Facility

$90.00

Hospital Charge Code	41561927
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

ZZ MEWISSEN 5/35/10/100

Facility

$228.22

Hospital Charge Code	41567248
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Brighton Health Commercial	$171.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MEWISSEN 5/35/10/65

Facility

$228.22

Hospital Charge Code	41567251
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Brighton Health Commercial	$171.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MEWISSEN 5/35/15/100

Facility

$228.22

Hospital Charge Code	41567256
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Brighton Health Commercial	$171.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MEWISSEN 5/35/5/100

Facility

$228.22

Hospital Charge Code	41567249
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Brighton Health Commercial	$171.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MEWISSEN 5/35/5/65

Facility

$228.22

Hospital Charge Code	41567250
Hospital Revenue Code	270
Min. Negotiated Rate	$79.88
Max. Negotiated Rate	$182.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.11
Rate for Payer: Aetna Government	$114.11
Rate for Payer: Brighton Health Commercial	$171.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$182.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.19
Rate for Payer: Group Health Inc Commercial	$114.11
Rate for Payer: Group Health Inc Medicare	$79.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.11
Rate for Payer: Hamaspik Choice Inc Medicare	$114.11

ZZ MICROCATH 3-2.3F 20 100

Facility

$489.04

Hospital Charge Code	41567351
Hospital Revenue Code	270
Min. Negotiated Rate	$171.16
Max. Negotiated Rate	$391.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$244.52
Rate for Payer: Aetna Government	$244.52
Rate for Payer: Brighton Health Commercial	$366.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$391.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$332.55
Rate for Payer: Group Health Inc Commercial	$244.52
Rate for Payer: Group Health Inc Medicare	$171.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$244.52
Rate for Payer: Hamaspik Choice Inc Medicare	$244.52

ZZ MICROCATH 3-2.3F 20 135

Facility

$489.04

Hospital Charge Code	41567352
Hospital Revenue Code	270
Min. Negotiated Rate	$171.16
Max. Negotiated Rate	$391.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$244.52
Rate for Payer: Aetna Government	$244.52
Rate for Payer: Brighton Health Commercial	$366.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$391.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$332.55
Rate for Payer: Group Health Inc Commercial	$244.52
Rate for Payer: Group Health Inc Medicare	$171.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$244.52
Rate for Payer: Hamaspik Choice Inc Medicare	$244.52

Know your out-of-pocket cost for care.

All Charges