St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BUR DIAMOND M-8D 2.9MMD/3.8L

Facility

$465.00

Hospital Charge Code	64904785
Hospital Revenue Code	270
Min. Negotiated Rate	$162.75
Max. Negotiated Rate	$372.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$255.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$232.50
Rate for Payer: Aetna Government	$232.50
Rate for Payer: Brighton Health Commercial	$348.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$372.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$316.20
Rate for Payer: Group Health Inc Commercial	$232.50
Rate for Payer: Group Health Inc Medicare	$162.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$232.50
Rate for Payer: Hamaspik Choice Inc Medicare	$232.50

BURENORPHINE+NALOXONE 8MG-2MG

Facility

$14.48

Hospital Charge Code	41656001
Hospital Revenue Code	636
Min. Negotiated Rate	$5.07
Max. Negotiated Rate	$9.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.24
Rate for Payer: Aetna Government	$7.24
Rate for Payer: Brighton Health Commercial	$8.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.33
Rate for Payer: Group Health Inc Commercial	$7.24
Rate for Payer: Group Health Inc Medicare	$5.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.24
Rate for Payer: Hamaspik Choice Inc Medicare	$7.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.41

BURENORPHINE+NALOXONE 8MG-2MG

Facility

$14.48

Hospital Charge Code	41656001
Hospital Revenue Code	636
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$7.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.24
Rate for Payer: Hamaspik Choice Inc Medicare	$7.24

BURETROL SET

Facility

$16.31

Hospital Charge Code	40509796
Hospital Revenue Code	260
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$76.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.16
Rate for Payer: Aetna Government	$8.16
Rate for Payer: Brighton Health Commercial	$12.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.09
Rate for Payer: Group Health Inc Commercial	$8.16
Rate for Payer: Group Health Inc Medicare	$5.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.16
Rate for Payer: Hamaspik Choice Inc Medicare	$8.16
Rate for Payer: United Healthcare Commercial	$76.00

BUR FLAME 6.0 X 48MM BRASSELER

Facility

$42.63

Hospital Charge Code	64904115
Hospital Revenue Code	270
Min. Negotiated Rate	$14.92
Max. Negotiated Rate	$34.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.32
Rate for Payer: Aetna Government	$21.32
Rate for Payer: Brighton Health Commercial	$31.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.99
Rate for Payer: Group Health Inc Commercial	$21.32
Rate for Payer: Group Health Inc Medicare	$14.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.32
Rate for Payer: Hamaspik Choice Inc Medicare	$21.32

BUR FORMULA BAR 12F RR 4MM

Facility

$54.35

Hospital Charge Code	64906052
Hospital Revenue Code	270
Min. Negotiated Rate	$19.02
Max. Negotiated Rate	$43.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.18
Rate for Payer: Aetna Government	$27.18
Rate for Payer: Brighton Health Commercial	$40.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.96
Rate for Payer: Group Health Inc Commercial	$27.18
Rate for Payer: Group Health Inc Medicare	$19.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.18
Rate for Payer: Hamaspik Choice Inc Medicare	$27.18

BUR FORMULA BAR 6 F RR 4MM

Facility

$271.75

Hospital Charge Code	64906051
Hospital Revenue Code	270
Min. Negotiated Rate	$95.11
Max. Negotiated Rate	$217.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$149.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$135.88
Rate for Payer: Aetna Government	$135.88
Rate for Payer: Brighton Health Commercial	$203.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.79
Rate for Payer: Group Health Inc Commercial	$135.88
Rate for Payer: Group Health Inc Medicare	$95.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.88
Rate for Payer: Hamaspik Choice Inc Medicare	$135.88

BUR HILAN ROSEN II 2.3MM

Facility

$137.32

Hospital Charge Code	40200474
Hospital Revenue Code	270
Min. Negotiated Rate	$48.06
Max. Negotiated Rate	$109.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$75.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$68.66
Rate for Payer: Aetna Government	$68.66
Rate for Payer: Brighton Health Commercial	$102.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$109.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.38
Rate for Payer: Group Health Inc Commercial	$68.66
Rate for Payer: Group Health Inc Medicare	$48.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.66
Rate for Payer: Hamaspik Choice Inc Medicare	$68.66

BUR JOIN

Facility

$168.08

Hospital Charge Code	64907321
Hospital Revenue Code	270
Min. Negotiated Rate	$58.83
Max. Negotiated Rate	$134.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$92.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$84.04
Rate for Payer: Aetna Government	$84.04
Rate for Payer: Brighton Health Commercial	$126.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$134.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$114.29
Rate for Payer: Group Health Inc Commercial	$84.04
Rate for Payer: Group Health Inc Medicare	$58.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$84.04
Rate for Payer: Hamaspik Choice Inc Medicare	$84.04

BUR MATCH HD FLUTE 3MMX10CM

Facility

$87.50

Hospital Charge Code	64904915
Hospital Revenue Code	270
Min. Negotiated Rate	$30.62
Max. Negotiated Rate	$70.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.75
Rate for Payer: Aetna Government	$43.75
Rate for Payer: Brighton Health Commercial	$65.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.50
Rate for Payer: Group Health Inc Commercial	$43.75
Rate for Payer: Group Health Inc Medicare	$30.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.75
Rate for Payer: Hamaspik Choice Inc Medicare	$43.75

BUR MATCH HEAD T14 2.5MM HEAD

Facility

$87.50

Hospital Charge Code	64904913
Hospital Revenue Code	270
Min. Negotiated Rate	$30.62
Max. Negotiated Rate	$70.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.75
Rate for Payer: Aetna Government	$43.75
Rate for Payer: Brighton Health Commercial	$65.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.50
Rate for Payer: Group Health Inc Commercial	$43.75
Rate for Payer: Group Health Inc Medicare	$30.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.75
Rate for Payer: Hamaspik Choice Inc Medicare	$43.75

BURN TRAY

Facility

$18.78

Hospital Charge Code	40200670
Hospital Revenue Code	270
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$15.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.39
Rate for Payer: Aetna Government	$9.39
Rate for Payer: Brighton Health Commercial	$14.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.77
Rate for Payer: Group Health Inc Commercial	$9.39
Rate for Payer: Group Health Inc Medicare	$6.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.39
Rate for Payer: Hamaspik Choice Inc Medicare	$9.39

BUR OVAL 4.0 X 55MM BRASSELER

Facility

$35.53

Hospital Charge Code	64904121
Hospital Revenue Code	270
Min. Negotiated Rate	$12.44
Max. Negotiated Rate	$28.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.76
Rate for Payer: Aetna Government	$17.76
Rate for Payer: Brighton Health Commercial	$26.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.16
Rate for Payer: Group Health Inc Commercial	$17.76
Rate for Payer: Group Health Inc Medicare	$12.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.76
Rate for Payer: Hamaspik Choice Inc Medicare	$17.76

BUR OVAL 4.0X55MM BRASSELER

Facility

$28.00

Hospital Charge Code	40201015
Hospital Revenue Code	270
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$22.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.00
Rate for Payer: Aetna Government	$14.00
Rate for Payer: Brighton Health Commercial	$21.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.04
Rate for Payer: Group Health Inc Commercial	$14.00
Rate for Payer: Group Health Inc Medicare	$9.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.00
Rate for Payer: Hamaspik Choice Inc Medicare	$14.00

BURR HOLES

Facility

$3,512.48

Service Code	HCPCS 61154
Hospital Charge Code	40000145
Hospital Revenue Code	360
Min. Negotiated Rate	$1,229.37
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,931.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,602.03
Rate for Payer: Aetna Government	$1,602.03
Rate for Payer: Brighton Health Commercial	$2,634.36
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: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$1,756.24
Rate for Payer: Group Health Inc Medicare	$1,229.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,756.24
Rate for Payer: Hamaspik Choice Inc Medicare	$1,756.24
Rate for Payer: United Healthcare Commercial	$1,496.00

BUR ROUND 3.2MM

Facility

$160.68

Hospital Charge Code	64904986
Hospital Revenue Code	270
Min. Negotiated Rate	$56.24
Max. Negotiated Rate	$128.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$80.34
Rate for Payer: Aetna Government	$80.34
Rate for Payer: Brighton Health Commercial	$120.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$109.26
Rate for Payer: Group Health Inc Commercial	$80.34
Rate for Payer: Group Health Inc Medicare	$56.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.34
Rate for Payer: Hamaspik Choice Inc Medicare	$80.34

BUR ROUND 4.0MM DIAMOND MED

Facility

$382.80

Hospital Charge Code	64904182
Hospital Revenue Code	270
Min. Negotiated Rate	$133.98
Max. Negotiated Rate	$306.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$210.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$191.40
Rate for Payer: Aetna Government	$191.40
Rate for Payer: Brighton Health Commercial	$287.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$306.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$260.30
Rate for Payer: Group Health Inc Commercial	$191.40
Rate for Payer: Group Health Inc Medicare	$133.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$191.40
Rate for Payer: Hamaspik Choice Inc Medicare	$191.40

BUR ROUND 6 FLUTE 4.0MM

Facility

$100.00

Hospital Charge Code	64904980
Hospital Revenue Code	270
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$80.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.00
Rate for Payer: Aetna Government	$50.00
Rate for Payer: Brighton Health Commercial	$75.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.00
Rate for Payer: Group Health Inc Commercial	$50.00
Rate for Payer: Group Health Inc Medicare	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.00
Rate for Payer: Hamaspik Choice Inc Medicare	$50.00

BUR ROUND CARBIDE 2.3 X 44.5MM

Facility

$12.88

Hospital Charge Code	64904855
Hospital Revenue Code	270
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$10.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.44
Rate for Payer: Aetna Government	$6.44
Rate for Payer: Brighton Health Commercial	$9.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.76
Rate for Payer: Group Health Inc Commercial	$6.44
Rate for Payer: Group Health Inc Medicare	$4.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.44
Rate for Payer: Hamaspik Choice Inc Medicare	$6.44

BUR SERRATED STAINLESS 2.3X67MM

Facility

$60.00

Hospital Charge Code	64904084
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

BUR TAPERED 1.2

Facility

$12.00

Hospital Charge Code	40201016
Hospital Revenue Code	270
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$9.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.00
Rate for Payer: Aetna Government	$6.00
Rate for Payer: Brighton Health Commercial	$9.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.16
Rate for Payer: Group Health Inc Commercial	$6.00
Rate for Payer: Group Health Inc Medicare	$4.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6.00

BUSHING FEMUR HINGE HMRS

Facility

$1,635.00

Service Code	HCPCS C1776
Hospital Charge Code	64907266
Hospital Revenue Code	278
Min. Negotiated Rate	$817.50
Max. Negotiated Rate	$817.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$817.50
Rate for Payer: Hamaspik Choice Inc Medicare	$817.50

BUSHING FEMUR HINGE HMRS

Facility

$1,635.00

Service Code	HCPCS C1776
Hospital Charge Code	64907266
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,716.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$899.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$981.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$817.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$940.12
Rate for Payer: EmblemHealth Commercial	$817.50
Rate for Payer: Fidelis Medicare Advantage	$1,716.75
Rate for Payer: Group Health Inc Commercial	$817.50
Rate for Payer: Group Health Inc Medicare	$572.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$817.50
Rate for Payer: Hamaspik Choice Inc Medicare	$817.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,062.75

BUSHING KRH DURATION

Facility

$1,031.25

Service Code	HCPCS C1776
Hospital Charge Code	64907265
Hospital Revenue Code	278
Min. Negotiated Rate	$515.62
Max. Negotiated Rate	$515.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$515.62
Rate for Payer: Hamaspik Choice Inc Medicare	$515.62

BUSHING KRH DURATION

Facility

$1,031.25

Service Code	HCPCS C1776
Hospital Charge Code	64907265
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,082.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$567.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$618.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$515.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$592.97
Rate for Payer: EmblemHealth Commercial	$515.62
Rate for Payer: Fidelis Medicare Advantage	$1,082.81
Rate for Payer: Group Health Inc Commercial	$515.62
Rate for Payer: Group Health Inc Medicare	$360.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$515.62
Rate for Payer: Hamaspik Choice Inc Medicare	$515.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$670.31

Know your out-of-pocket cost for care.

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