St. Barnabas Hospital

All Charges

Charge

Type

Price

CLIP APPLIER ENDO 10MM LARGE

Facility OP

$640.30

Hospital Charge Code	40200477
Hospital Revenue Code	270
Min. Negotiated Rate	$224.10
Max. Negotiated Rate	$512.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$352.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$320.15
Rate for Payer: Aetna Government	$320.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$512.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$435.40
Rate for Payer: Group Health Inc Commercial	$320.15
Rate for Payer: Group Health Inc Medicare	$224.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$320.15
Rate for Payer: Hamaspik Choice Inc Medicare	$320.15

CLIP APPLIER ENDO 10MM M/L

Facility OP

$205.52

Hospital Charge Code	40200412
Hospital Revenue Code	270
Min. Negotiated Rate	$71.93
Max. Negotiated Rate	$164.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$113.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$102.76
Rate for Payer: Aetna Government	$102.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$164.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.75
Rate for Payer: Group Health Inc Commercial	$102.76
Rate for Payer: Group Health Inc Medicare	$71.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.76
Rate for Payer: Hamaspik Choice Inc Medicare	$102.76

CLIP APPLIER LARGE MULTIPLE

Facility OP

$205.52

Hospital Charge Code	40200478
Hospital Revenue Code	270
Min. Negotiated Rate	$71.93
Max. Negotiated Rate	$164.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$113.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$102.76
Rate for Payer: Aetna Government	$102.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$164.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.75
Rate for Payer: Group Health Inc Commercial	$102.76
Rate for Payer: Group Health Inc Medicare	$71.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.76
Rate for Payer: Hamaspik Choice Inc Medicare	$102.76

CLIP CLOSED TUBE

Facility OP

$273.75

Hospital Charge Code	64907235
Hospital Revenue Code	270
Min. Negotiated Rate	$95.81
Max. Negotiated Rate	$219.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$150.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$136.88
Rate for Payer: Aetna Government	$136.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$219.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$186.15
Rate for Payer: Group Health Inc Commercial	$136.88
Rate for Payer: Group Health Inc Medicare	$95.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.88
Rate for Payer: Hamaspik Choice Inc Medicare	$136.88

CLIP ENDO APPLIER

Facility OP

$185.08

Hospital Charge Code	64907085
Hospital Revenue Code	270
Min. Negotiated Rate	$64.78
Max. Negotiated Rate	$148.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$101.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$92.54
Rate for Payer: Aetna Government	$92.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$148.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$125.85
Rate for Payer: Group Health Inc Commercial	$92.54
Rate for Payer: Group Health Inc Medicare	$64.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$92.54
Rate for Payer: Hamaspik Choice Inc Medicare	$92.54

CLIP MULTIPLE MEDIUM #MCM20

Facility OP

$128.32

Hospital Charge Code	40200410
Hospital Revenue Code	270
Min. Negotiated Rate	$44.91
Max. Negotiated Rate	$102.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$64.16
Rate for Payer: Aetna Government	$64.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$102.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$87.26
Rate for Payer: Group Health Inc Commercial	$64.16
Rate for Payer: Group Health Inc Medicare	$44.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$64.16
Rate for Payer: Hamaspik Choice Inc Medicare	$64.16

CLIP MULTIPLE SMALL #MCS20

Facility OP

$127.74

Hospital Charge Code	40200411
Hospital Revenue Code	270
Min. Negotiated Rate	$44.71
Max. Negotiated Rate	$102.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.87
Rate for Payer: Aetna Government	$63.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$102.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.86
Rate for Payer: Group Health Inc Commercial	$63.87
Rate for Payer: Group Health Inc Medicare	$44.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.87
Rate for Payer: Hamaspik Choice Inc Medicare	$63.87

CLIP OVERSCOPE 12/6 GC

Facility OP

$1,347.50

Hospital Charge Code	64905529
Hospital Revenue Code	270
Min. Negotiated Rate	$471.62
Max. Negotiated Rate	$1,078.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$741.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$673.75
Rate for Payer: Aetna Government	$673.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,078.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$916.30
Rate for Payer: Group Health Inc Commercial	$673.75
Rate for Payer: Group Health Inc Medicare	$471.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$673.75
Rate for Payer: Hamaspik Choice Inc Medicare	$673.75

CLIP RESOLUTION 360 235CM

Facility OP

$413.82

Hospital Charge Code	64906814
Hospital Revenue Code	279
Min. Negotiated Rate	$144.84
Max. Negotiated Rate	$331.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$206.91
Rate for Payer: Aetna Government	$206.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.40
Rate for Payer: Group Health Inc Commercial	$206.91
Rate for Payer: Group Health Inc Medicare	$144.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.91
Rate for Payer: Hamaspik Choice Inc Medicare	$206.91

CLIP RETRACTABLE PURELL GEAR

Facility OP

$2.37

Hospital Charge Code	64903458
Hospital Revenue Code	270
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$1.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.18
Rate for Payer: Aetna Government	$1.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.61
Rate for Payer: Group Health Inc Commercial	$1.18
Rate for Payer: Group Health Inc Medicare	$0.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1.18

CLIP SCALP RANEY

Facility OP

$2.80

Hospital Charge Code	64903984
Hospital Revenue Code	270
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$2.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.40
Rate for Payer: Aetna Government	$1.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.90
Rate for Payer: Group Health Inc Commercial	$1.40
Rate for Payer: Group Health Inc Medicare	$0.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1.40

CLIP SCREWDRIVER TUBE F/INT

Facility OP

$273.75

Hospital Charge Code	64904535
Hospital Revenue Code	270
Min. Negotiated Rate	$95.81
Max. Negotiated Rate	$219.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$150.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$136.88
Rate for Payer: Aetna Government	$136.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$219.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$186.15
Rate for Payer: Group Health Inc Commercial	$136.88
Rate for Payer: Group Health Inc Medicare	$95.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.88
Rate for Payer: Hamaspik Choice Inc Medicare	$136.88

CLMP BLLDG WLDN MINATURE3.4CM STR

Facility OP

$260.00

Hospital Charge Code	40200837
Hospital Revenue Code	270
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$208.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00

CLMP BLLDG WLDN MINATURE3.4 CURVD

Facility OP

$268.00

Hospital Charge Code	40200836
Hospital Revenue Code	270
Min. Negotiated Rate	$93.80
Max. Negotiated Rate	$214.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$147.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.00
Rate for Payer: Aetna Government	$134.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.24
Rate for Payer: Group Health Inc Commercial	$134.00
Rate for Payer: Group Health Inc Medicare	$93.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$134.00
Rate for Payer: Hamaspik Choice Inc Medicare	$134.00

CLOBAZAM 10MG TAB

Facility OP

$13.00

Hospital Charge Code	41655975
Hospital Revenue Code	250
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$10.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.50
Rate for Payer: Aetna Government	$6.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.84
Rate for Payer: Group Health Inc Commercial	$6.50
Rate for Payer: Group Health Inc Medicare	$4.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.45

CLOBAZAM 10MG TAB

Facility OP

$13.00

Hospital Charge Code	41645975
Hospital Revenue Code	250
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$10.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.50
Rate for Payer: Aetna Government	$6.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.84
Rate for Payer: Group Health Inc Commercial	$6.50
Rate for Payer: Group Health Inc Medicare	$4.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.45

CLOBETASOL PROPIONATE 0.05 % CREAM

Facility OP

$4.20

Hospital Charge Code	41643999
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$3.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.10
Rate for Payer: Aetna Government	$2.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.86
Rate for Payer: Group Health Inc Commercial	$2.10
Rate for Payer: Group Health Inc Medicare	$1.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.10
Rate for Payer: Hamaspik Choice Inc Medicare	$2.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.73

CLOBETASOL PROPIONATE 0.05 % CREAM

Facility OP

$4.20

Hospital Charge Code	41653999
Hospital Revenue Code	250
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$3.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.10
Rate for Payer: Aetna Government	$2.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.86
Rate for Payer: Group Health Inc Commercial	$2.10
Rate for Payer: Group Health Inc Medicare	$1.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.10
Rate for Payer: Hamaspik Choice Inc Medicare	$2.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.73

CLOBETASOL PROPIONATE 0.05% OINTMENT

Facility OP

$11.48

Hospital Charge Code	41642946
Hospital Revenue Code	250
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$9.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.74
Rate for Payer: Aetna Government	$5.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.81
Rate for Payer: Group Health Inc Commercial	$5.74
Rate for Payer: Group Health Inc Medicare	$4.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.74
Rate for Payer: Hamaspik Choice Inc Medicare	$5.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.46

CLOBETASOL PROPIONATE 0.05% OINTMENT

Facility OP

$11.48

Hospital Charge Code	41652946
Hospital Revenue Code	250
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$9.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.74
Rate for Payer: Aetna Government	$5.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.81
Rate for Payer: Group Health Inc Commercial	$5.74
Rate for Payer: Group Health Inc Medicare	$4.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.74
Rate for Payer: Hamaspik Choice Inc Medicare	$5.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.46

CLOMIPRAMINE 25 MG CAP

Facility OP

$0.43

Hospital Charge Code	41644042
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.22
Rate for Payer: Aetna Government	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.29
Rate for Payer: Group Health Inc Commercial	$0.22
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.28

CLOMIPRAMINE 25 MG CAP

Facility OP

$0.43

Hospital Charge Code	41654042
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.22
Rate for Payer: Aetna Government	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.29
Rate for Payer: Group Health Inc Commercial	$0.22
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.28

CLONAZEPAM 0.5 MG TAB

Facility OP

$0.08

Hospital Charge Code	41644265
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

CLONAZEPAM 0.5 MG TAB

Facility OP

$0.08

Hospital Charge Code	41654265
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

CLONAZEPAM 1 MG TAB

Facility OP

$0.12

Hospital Charge Code	41654264
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.08
Rate for Payer: Group Health Inc Commercial	$0.06
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.06
Rate for Payer: Hamaspik Choice Inc Medicare	$0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.08

Price Transparency.

All Charges