St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CABAZITAXEL 60 MG/1.5ML IV SOLN [105644]

Facility

$11,095.32

Service Code	HCPCS J9043
Hospital Charge Code	00024582411
Hospital Revenue Code	278
Min. Negotiated Rate	$5,547.66
Max. Negotiated Rate	$5,547.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,547.66
Rate for Payer: Hamaspik Choice Inc Medicare	$5,547.66

CABAZITAXEL 60 MG/1.5ML IV SOLN [105644]

Facility

$11,095.32

Service Code	HCPCS J9043
Hospital Charge Code	00024582411
Hospital Revenue Code	278
Min. Negotiated Rate	$168.36
Max. Negotiated Rate	$7,211.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,102.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$210.45
Rate for Payer: Aetna Government	$210.45
Rate for Payer: Brighton Health Commercial	$6,657.19
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$210.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,547.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,379.81
Rate for Payer: Elderplan Medicare Advantage	$210.45
Rate for Payer: EmblemHealth Commercial	$5,547.66
Rate for Payer: Fidelis Medicare Advantage	$210.45
Rate for Payer: Group Health Inc Commercial	$210.45
Rate for Payer: Group Health Inc Medicare	$210.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,547.66
Rate for Payer: Hamaspik Choice Inc Medicare	$5,547.66
Rate for Payer: Healthfirst Medicare Advantage	$178.89
Rate for Payer: Healthfirst QHP	$210.45
Rate for Payer: Humana Medicare	$214.66
Rate for Payer: Senior Whole Health Medicare Advantage	$210.45
Rate for Payer: United Healthcare Medicare Advantage	$210.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,211.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$168.36

CABLE 20 BEADED

Facility

$1,280.00

Hospital Charge Code	64905856
Hospital Revenue Code	270
Min. Negotiated Rate	$448.00
Max. Negotiated Rate	$1,024.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$704.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$640.00
Rate for Payer: Aetna Government	$640.00
Rate for Payer: Brighton Health Commercial	$960.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,024.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$870.40
Rate for Payer: Group Health Inc Commercial	$640.00
Rate for Payer: Group Health Inc Medicare	$448.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$640.00
Rate for Payer: Hamaspik Choice Inc Medicare	$640.00

CABLE 3 LEAD LIFEPAK

Facility

$244.38

Hospital Charge Code	64903102
Hospital Revenue Code	270
Min. Negotiated Rate	$85.53
Max. Negotiated Rate	$195.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$134.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$122.19
Rate for Payer: Aetna Government	$122.19
Rate for Payer: Brighton Health Commercial	$183.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$166.18
Rate for Payer: Group Health Inc Commercial	$122.19
Rate for Payer: Group Health Inc Medicare	$85.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.19
Rate for Payer: Hamaspik Choice Inc Medicare	$122.19

CABLE MAS PLIF LIGHT, STERILE

Facility

$1,539.35

Hospital Charge Code	64906131
Hospital Revenue Code	270
Min. Negotiated Rate	$538.77
Max. Negotiated Rate	$1,231.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$846.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$769.68
Rate for Payer: Aetna Government	$769.68
Rate for Payer: Brighton Health Commercial	$1,154.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,231.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,046.76
Rate for Payer: Group Health Inc Commercial	$769.68
Rate for Payer: Group Health Inc Medicare	$538.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$769.68
Rate for Payer: Hamaspik Choice Inc Medicare	$769.68

CABLE ORTHOPEDIC 2MM DIA COBAL

Facility

$1,288.63

Hospital Charge Code	64905780
Hospital Revenue Code	270
Min. Negotiated Rate	$451.02
Max. Negotiated Rate	$1,030.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$708.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$644.32
Rate for Payer: Aetna Government	$644.32
Rate for Payer: Brighton Health Commercial	$966.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,030.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$876.27
Rate for Payer: Group Health Inc Commercial	$644.32
Rate for Payer: Group Health Inc Medicare	$451.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$644.32
Rate for Payer: Hamaspik Choice Inc Medicare	$644.32

CABLE PACEMAKER LONG 12FTL ART

Facility

$168.75

Service Code	HCPCS C1785
Hospital Charge Code	64901115
Hospital Revenue Code	278
Min. Negotiated Rate	$59.06
Max. Negotiated Rate	$275.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$92.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Brighton Health Commercial	$101.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$84.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.03
Rate for Payer: EmblemHealth Commercial	$84.38
Rate for Payer: Fidelis Medicare Advantage	$177.19
Rate for Payer: Group Health Inc Commercial	$84.38
Rate for Payer: Group Health Inc Medicare	$59.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$84.38
Rate for Payer: Hamaspik Choice Inc Medicare	$84.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$109.69

CABLE PACEMAKER LONG 12FTL ART

Facility

$168.75

Service Code	HCPCS C1785
Hospital Charge Code	64901115
Hospital Revenue Code	278
Min. Negotiated Rate	$84.38
Max. Negotiated Rate	$84.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$84.38
Rate for Payer: Hamaspik Choice Inc Medicare	$84.38

CABLE PATIENT SEER LIGHT

Facility

$533.88

Hospital Charge Code	64903314
Hospital Revenue Code	270
Min. Negotiated Rate	$186.86
Max. Negotiated Rate	$427.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$293.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$266.94
Rate for Payer: Aetna Government	$266.94
Rate for Payer: Brighton Health Commercial	$400.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$427.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$363.04
Rate for Payer: Group Health Inc Commercial	$266.94
Rate for Payer: Group Health Inc Medicare	$186.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$266.94
Rate for Payer: Hamaspik Choice Inc Medicare	$266.94

CABLE PLTE BONE 1.8MM-00223200318

Facility

$360.00

Service Code	HCPCS C1713
Hospital Charge Code	64906409
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$180.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$180.00
Rate for Payer: Hamaspik Choice Inc Medicare	$180.00

CABLE PLTE BONE 1.8MM-00223200318

Facility

$360.00

Service Code	HCPCS C1713
Hospital Charge Code	64906409
Hospital Revenue Code	278
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$378.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$198.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$216.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$180.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$207.00
Rate for Payer: EmblemHealth Commercial	$180.00
Rate for Payer: Fidelis Medicare Advantage	$378.00
Rate for Payer: Group Health Inc Commercial	$180.00
Rate for Payer: Group Health Inc Medicare	$126.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$180.00
Rate for Payer: Hamaspik Choice Inc Medicare	$180.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$234.00

CABLE SPO2 REUSEABLE 2533

Facility

$320.00

Hospital Charge Code	64906829
Hospital Revenue Code	270
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$256.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$176.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$160.00
Rate for Payer: Aetna Government	$160.00
Rate for Payer: Brighton Health Commercial	$240.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$256.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$217.60
Rate for Payer: Group Health Inc Commercial	$160.00
Rate for Payer: Group Health Inc Medicare	$112.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$160.00

CABLE, SURG SST 1.8MM X 559

Facility

$1,260.00

Hospital Charge Code	64906176
Hospital Revenue Code	270
Min. Negotiated Rate	$441.00
Max. Negotiated Rate	$1,008.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$693.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$630.00
Rate for Payer: Aetna Government	$630.00
Rate for Payer: Brighton Health Commercial	$945.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,008.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$856.80
Rate for Payer: Group Health Inc Commercial	$630.00
Rate for Payer: Group Health Inc Medicare	$441.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$630.00
Rate for Payer: Hamaspik Choice Inc Medicare	$630.00

CABLE WAND CAPSURE30 3.0MM

Facility

$1,055.00

Hospital Charge Code	64903101
Hospital Revenue Code	270
Min. Negotiated Rate	$369.25
Max. Negotiated Rate	$844.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$580.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$527.50
Rate for Payer: Aetna Government	$527.50
Rate for Payer: Brighton Health Commercial	$791.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$844.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$717.40
Rate for Payer: Group Health Inc Commercial	$527.50
Rate for Payer: Group Health Inc Medicare	$369.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$527.50
Rate for Payer: Hamaspik Choice Inc Medicare	$527.50

CABLE WCRIMP 1.8MM

Facility

$1,130.00

Hospital Charge Code	64907047
Hospital Revenue Code	270
Min. Negotiated Rate	$395.50
Max. Negotiated Rate	$904.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$621.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$565.00
Rate for Payer: Aetna Government	$565.00
Rate for Payer: Brighton Health Commercial	$847.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$904.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$768.40
Rate for Payer: Group Health Inc Commercial	$565.00
Rate for Payer: Group Health Inc Medicare	$395.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$565.00
Rate for Payer: Hamaspik Choice Inc Medicare	$565.00

CABOTEGRAVIR

Facility

$0.01

Hospital Charge Code	41650248
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CABOTEGRAVIR

Facility

$0.01

Hospital Charge Code	41640248
Hospital Revenue Code	250
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CABOTEGRAVIR 200MG/ML

Facility

$14.80

Service Code	HCPCS J3490
Hospital Charge Code	41640334
Hospital Revenue Code	636
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$9.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.40
Rate for Payer: Aetna Government	$7.40
Rate for Payer: Brighton Health Commercial	$8.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.51
Rate for Payer: Group Health Inc Commercial	$7.40
Rate for Payer: Group Health Inc Medicare	$5.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.40
Rate for Payer: Hamaspik Choice Inc Medicare	$7.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.62

CABOTEGRAVIR 200MG/ML

Facility

$14.80

Service Code	HCPCS J3490
Hospital Charge Code	41650334
Hospital Revenue Code	636
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$7.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.40
Rate for Payer: Hamaspik Choice Inc Medicare	$7.40

CABOTEGRAVIR 200MG/ML

Facility

$14.80

Service Code	HCPCS J3490
Hospital Charge Code	41650334
Hospital Revenue Code	636
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$9.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.40
Rate for Payer: Aetna Government	$7.40
Rate for Payer: Brighton Health Commercial	$8.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.51
Rate for Payer: Group Health Inc Commercial	$7.40
Rate for Payer: Group Health Inc Medicare	$5.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.40
Rate for Payer: Hamaspik Choice Inc Medicare	$7.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.62

CABOTEGRAVIR 200MG/ML

Facility

$14.80

Service Code	HCPCS J3490
Hospital Charge Code	41640334
Hospital Revenue Code	636
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$7.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.40
Rate for Payer: Hamaspik Choice Inc Medicare	$7.40

CABOTEGRAVIR ER 600 MG/3ML IM SUER [182732]

Facility

$1,547.60

Service Code	HCPCS J0739
Hospital Charge Code	49702026423
Hospital Revenue Code	250
Min. Negotiated Rate	$541.66
Max. Negotiated Rate	$1,238.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$851.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$773.80
Rate for Payer: Aetna Government	$773.80
Rate for Payer: Brighton Health Commercial	$1,160.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,238.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,052.37
Rate for Payer: Group Health Inc Commercial	$773.80
Rate for Payer: Group Health Inc Medicare	$541.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$773.80
Rate for Payer: Hamaspik Choice Inc Medicare	$773.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,005.94

CABOTEGRAVIR + RILPIVIRINE 4ML

Facility

$23.76

Service Code	HCPCS J3490
Hospital Charge Code	41640249
Hospital Revenue Code	636
Min. Negotiated Rate	$11.88
Max. Negotiated Rate	$11.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.88
Rate for Payer: Hamaspik Choice Inc Medicare	$11.88

CABOTEGRAVIR + RILPIVIRINE 4ML

Facility

$23.76

Service Code	HCPCS J3490
Hospital Charge Code	41650249
Hospital Revenue Code	636
Min. Negotiated Rate	$11.88
Max. Negotiated Rate	$11.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.88
Rate for Payer: Hamaspik Choice Inc Medicare	$11.88

CABOTEGRAVIR + RILPIVIRINE 4ML

Facility

$23.76

Service Code	HCPCS J3490
Hospital Charge Code	41640249
Hospital Revenue Code	636
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$15.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.88
Rate for Payer: Aetna Government	$11.88
Rate for Payer: Brighton Health Commercial	$14.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.66
Rate for Payer: Group Health Inc Commercial	$11.88
Rate for Payer: Group Health Inc Medicare	$8.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.88
Rate for Payer: Hamaspik Choice Inc Medicare	$11.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.44

Know your out-of-pocket cost for care.

All Charges