St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CANDESARTAN CILEXETIL 16 MG PO TABS [23231]

Facility

$5.39

Service Code	NDC 60687024125
Hospital Charge Code	60687024125
Hospital Revenue Code	250
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$4.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.69
Rate for Payer: Aetna Government	$2.69
Rate for Payer: Brighton Health Commercial	$4.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.66
Rate for Payer: Group Health Inc Commercial	$2.69
Rate for Payer: Group Health Inc Medicare	$1.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.69
Rate for Payer: Hamaspik Choice Inc Medicare	$2.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.50

CANDESARTAN CILEXETIL 16 MG PO TABS [23231]

Facility

$3.06

Service Code	NDC 33342011607
Hospital Charge Code	33342011607
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$2.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.53
Rate for Payer: Aetna Government	$1.53
Rate for Payer: Brighton Health Commercial	$2.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.08
Rate for Payer: Group Health Inc Commercial	$1.53
Rate for Payer: Group Health Inc Medicare	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.53
Rate for Payer: Hamaspik Choice Inc Medicare	$1.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.99

CANDESARTAN CILEXETIL 4 MG PO TABS [23229]

Facility

$3.06

Service Code	NDC 33342011407
Hospital Charge Code	33342011407
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$2.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.53
Rate for Payer: Aetna Government	$1.53
Rate for Payer: Brighton Health Commercial	$2.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.08
Rate for Payer: Group Health Inc Commercial	$1.53
Rate for Payer: Group Health Inc Medicare	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.53
Rate for Payer: Hamaspik Choice Inc Medicare	$1.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.99

CANDESARTAN CILEXETIL 4 MG PO TABS [23229]

Facility

$3.06

Service Code	NDC 00378322493
Hospital Charge Code	00378322493
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$2.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.53
Rate for Payer: Aetna Government	$1.53
Rate for Payer: Brighton Health Commercial	$2.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.08
Rate for Payer: Group Health Inc Commercial	$1.53
Rate for Payer: Group Health Inc Medicare	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.53
Rate for Payer: Hamaspik Choice Inc Medicare	$1.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.99

CANDESARTAN CILEXETIL 8 MG PO TABS [23230]

Facility

$9.20

Service Code	NDC 62559064130
Hospital Charge Code	62559064130
Hospital Revenue Code	250
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$7.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.60
Rate for Payer: Aetna Government	$4.60
Rate for Payer: Brighton Health Commercial	$6.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.26
Rate for Payer: Group Health Inc Commercial	$4.60
Rate for Payer: Group Health Inc Medicare	$3.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.60
Rate for Payer: Hamaspik Choice Inc Medicare	$4.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.98

CANDESARTAN CILEXETIL 8 MG PO TABS [23230]

Facility

$3.06

Service Code	NDC 00378322593
Hospital Charge Code	00378322593
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$2.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.53
Rate for Payer: Aetna Government	$1.53
Rate for Payer: Brighton Health Commercial	$2.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.08
Rate for Payer: Group Health Inc Commercial	$1.53
Rate for Payer: Group Health Inc Medicare	$1.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.53
Rate for Payer: Hamaspik Choice Inc Medicare	$1.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.99

CANDO VESTIBULAR DISC 60CM 23.6

Facility

$99.98

Hospital Charge Code	64903311
Hospital Revenue Code	270
Min. Negotiated Rate	$34.99
Max. Negotiated Rate	$79.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$54.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$49.99
Rate for Payer: Aetna Government	$49.99
Rate for Payer: Brighton Health Commercial	$74.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.99
Rate for Payer: Group Health Inc Commercial	$49.99
Rate for Payer: Group Health Inc Medicare	$34.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.99
Rate for Payer: Hamaspik Choice Inc Medicare	$49.99

CANISTER 2500C 2-ELBOW

Facility

$7.81

Hospital Charge Code	64902042
Hospital Revenue Code	270
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$6.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.90
Rate for Payer: Aetna Government	$3.90
Rate for Payer: Brighton Health Commercial	$5.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.31
Rate for Payer: Group Health Inc Commercial	$3.90
Rate for Payer: Group Health Inc Medicare	$2.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.90
Rate for Payer: Hamaspik Choice Inc Medicare	$3.90

CANISTER ABTHERA 1000ML

Facility

$25.88

Hospital Charge Code	64901527
Hospital Revenue Code	270
Min. Negotiated Rate	$9.06
Max. Negotiated Rate	$20.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.94
Rate for Payer: Aetna Government	$12.94
Rate for Payer: Brighton Health Commercial	$19.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.60
Rate for Payer: Group Health Inc Commercial	$12.94
Rate for Payer: Group Health Inc Medicare	$9.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.94
Rate for Payer: Hamaspik Choice Inc Medicare	$12.94

CANISTER INDIGO SYSTEM

Facility

$720.00

Hospital Charge Code	64906846
Hospital Revenue Code	270
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$576.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$396.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$360.00
Rate for Payer: Aetna Government	$360.00
Rate for Payer: Brighton Health Commercial	$540.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$576.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$489.60
Rate for Payer: Group Health Inc Commercial	$360.00
Rate for Payer: Group Health Inc Medicare	$252.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$360.00
Rate for Payer: Hamaspik Choice Inc Medicare	$360.00

CANISTER SUCTION 1200CC SEP-T-VAC

Facility

$5.28

Hospital Charge Code	64903279
Hospital Revenue Code	270
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$4.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.64
Rate for Payer: Aetna Government	$2.64
Rate for Payer: Brighton Health Commercial	$3.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.59
Rate for Payer: Group Health Inc Commercial	$2.64
Rate for Payer: Group Health Inc Medicare	$1.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.64
Rate for Payer: Hamaspik Choice Inc Medicare	$2.64

CANISTER VAC ATS W/GEL 500M A

Facility

$882.80

Hospital Charge Code	64903286
Hospital Revenue Code	270
Min. Negotiated Rate	$308.98
Max. Negotiated Rate	$706.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$485.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$441.40
Rate for Payer: Aetna Government	$441.40
Rate for Payer: Brighton Health Commercial	$662.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$706.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$600.30
Rate for Payer: Group Health Inc Commercial	$441.40
Rate for Payer: Group Health Inc Medicare	$308.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$441.40
Rate for Payer: Hamaspik Choice Inc Medicare	$441.40

CANISTER VAC ATS W/GEL 500M B

Facility

$509.18

Hospital Charge Code	64903288
Hospital Revenue Code	270
Min. Negotiated Rate	$178.21
Max. Negotiated Rate	$407.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$280.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$254.59
Rate for Payer: Aetna Government	$254.59
Rate for Payer: Brighton Health Commercial	$381.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$407.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$346.24
Rate for Payer: Group Health Inc Commercial	$254.59
Rate for Payer: Group Health Inc Medicare	$178.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$254.59
Rate for Payer: Hamaspik Choice Inc Medicare	$254.59

CANISTER VAC ATS W/GEL500ML

Facility

$96.57

Hospital Charge Code	64901126
Hospital Revenue Code	270
Min. Negotiated Rate	$33.80
Max. Negotiated Rate	$77.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$48.28
Rate for Payer: Aetna Government	$48.28
Rate for Payer: Brighton Health Commercial	$72.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.67
Rate for Payer: Group Health Inc Commercial	$48.28
Rate for Payer: Group Health Inc Medicare	$33.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.28
Rate for Payer: Hamaspik Choice Inc Medicare	$48.28

CANISTER VAC ATS W/O GEL 500 A

Facility

$424.50

Hospital Charge Code	64903304
Hospital Revenue Code	270
Min. Negotiated Rate	$148.58
Max. Negotiated Rate	$339.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$233.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$212.25
Rate for Payer: Aetna Government	$212.25
Rate for Payer: Brighton Health Commercial	$318.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$339.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.66
Rate for Payer: Group Health Inc Commercial	$212.25
Rate for Payer: Group Health Inc Medicare	$148.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$212.25
Rate for Payer: Hamaspik Choice Inc Medicare	$212.25

CANISTER VAC FREEDOM W/GEL

Facility

$845.40

Hospital Charge Code	64903340
Hospital Revenue Code	270
Min. Negotiated Rate	$295.89
Max. Negotiated Rate	$676.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$464.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$422.70
Rate for Payer: Aetna Government	$422.70
Rate for Payer: Brighton Health Commercial	$634.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$676.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$574.87
Rate for Payer: Group Health Inc Commercial	$422.70
Rate for Payer: Group Health Inc Medicare	$295.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$422.70
Rate for Payer: Hamaspik Choice Inc Medicare	$422.70

CANISTER VAC FREEDOM W/GEL 300

Facility

$477.95

Hospital Charge Code	64903306
Hospital Revenue Code	270
Min. Negotiated Rate	$167.28
Max. Negotiated Rate	$382.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$262.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$238.98
Rate for Payer: Aetna Government	$238.98
Rate for Payer: Brighton Health Commercial	$358.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$382.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$325.01
Rate for Payer: Group Health Inc Commercial	$238.98
Rate for Payer: Group Health Inc Medicare	$167.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$238.98
Rate for Payer: Hamaspik Choice Inc Medicare	$238.98

CANISTER VAC ULTA 1000ML

Facility

$148.41

Hospital Charge Code	64901535
Hospital Revenue Code	270
Min. Negotiated Rate	$51.94
Max. Negotiated Rate	$118.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$74.20
Rate for Payer: Aetna Government	$74.20
Rate for Payer: Brighton Health Commercial	$111.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$118.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$100.92
Rate for Payer: Group Health Inc Commercial	$74.20
Rate for Payer: Group Health Inc Medicare	$51.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.20
Rate for Payer: Hamaspik Choice Inc Medicare	$74.20

CANISTER VAC ULTA 500ML

Facility

$91.74

Hospital Charge Code	64901537
Hospital Revenue Code	270
Min. Negotiated Rate	$32.11
Max. Negotiated Rate	$73.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$50.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.87
Rate for Payer: Aetna Government	$45.87
Rate for Payer: Brighton Health Commercial	$68.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$73.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$62.38
Rate for Payer: Group Health Inc Commercial	$45.87
Rate for Payer: Group Health Inc Medicare	$32.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.87
Rate for Payer: Hamaspik Choice Inc Medicare	$45.87

CANNABINOID CONFIRMATION, UR

Facility

$70.00

Service Code	HCPCS 80349
Hospital Charge Code	40609018
Hospital Revenue Code	300
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$56.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$52.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.60
Rate for Payer: Group Health Inc Commercial	$35.00
Rate for Payer: Group Health Inc Medicare	$24.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.00
Rate for Payer: Hamaspik Choice Inc Medicare	$35.00
Rate for Payer: United Healthcare Commercial	$21.99

CANN COUNTERSINK 4.0MM SCRW W/AO

Facility

$392.00

Service Code	HCPCS C1776
Hospital Charge Code	40205127
Hospital Revenue Code	278
Min. Negotiated Rate	$196.00
Max. Negotiated Rate	$196.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.00
Rate for Payer: Hamaspik Choice Inc Medicare	$196.00

CANN COUNTERSINK 4.0MM SCRW W/AO

Facility

$392.00

Service Code	HCPCS C1776
Hospital Charge Code	40205127
Hospital Revenue Code	278
Min. Negotiated Rate	$137.20
Max. Negotiated Rate	$411.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$215.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$235.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$196.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$225.40
Rate for Payer: EmblemHealth Commercial	$196.00
Rate for Payer: Fidelis Medicare Advantage	$411.60
Rate for Payer: Group Health Inc Commercial	$196.00
Rate for Payer: Group Health Inc Medicare	$137.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.00
Rate for Payer: Hamaspik Choice Inc Medicare	$196.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$254.80

CANN CRYSTAL SMOOTH 5.75MMX7CM

Facility

$50.00

Hospital Charge Code	40200955
Hospital Revenue Code	270
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$40.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.00
Rate for Payer: Aetna Government	$25.00
Rate for Payer: Brighton Health Commercial	$37.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.00
Rate for Payer: Group Health Inc Commercial	$25.00
Rate for Payer: Group Health Inc Medicare	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.00
Rate for Payer: Hamaspik Choice Inc Medicare	$25.00

CANN DRILL 4.9MM W/AO FITTING

Facility

$484.00

Service Code	HCPCS C1713
Hospital Charge Code	40200525
Hospital Revenue Code	278
Min. Negotiated Rate	$242.00
Max. Negotiated Rate	$242.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.00
Rate for Payer: Hamaspik Choice Inc Medicare	$242.00

CANN DRILL 4.9MM W/AO FITTING

Facility

$484.00

Service Code	HCPCS C1713
Hospital Charge Code	40200525
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$508.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$266.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$290.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$242.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$278.30
Rate for Payer: EmblemHealth Commercial	$242.00
Rate for Payer: Fidelis Medicare Advantage	$508.20
Rate for Payer: Group Health Inc Commercial	$242.00
Rate for Payer: Group Health Inc Medicare	$169.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.00
Rate for Payer: Hamaspik Choice Inc Medicare	$242.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$314.60

Know your out-of-pocket cost for care.

All Charges