St. Barnabas Hospital

All Charges

Charge

Type

Price

COLISTIMETHATE 150 MG INJ

Facility IP

$21.86

Service Code	HCPCS J0770
Hospital Charge Code	41642826
Hospital Revenue Code	636
Min. Negotiated Rate	$10.93
Max. Negotiated Rate	$10.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.93
Rate for Payer: Hamaspik Choice Inc Medicare	$10.93

COLLAGENASE 10GM TOPICAL OINTMENT

Facility OP

$175.57

Hospital Charge Code	41657809
Hospital Revenue Code	250
Min. Negotiated Rate	$61.45
Max. Negotiated Rate	$140.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$96.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$87.78
Rate for Payer: Aetna Government	$87.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$140.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$119.39
Rate for Payer: Group Health Inc Commercial	$87.78
Rate for Payer: Group Health Inc Medicare	$61.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.78
Rate for Payer: Hamaspik Choice Inc Medicare	$87.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$114.12

COLLAGENASE 10GM TOPICAL OINTMENT

Facility OP

$175.57

Hospital Charge Code	41647809
Hospital Revenue Code	250
Min. Negotiated Rate	$61.45
Max. Negotiated Rate	$140.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$96.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$87.78
Rate for Payer: Aetna Government	$87.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$140.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$119.39
Rate for Payer: Group Health Inc Commercial	$87.78
Rate for Payer: Group Health Inc Medicare	$61.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.78
Rate for Payer: Hamaspik Choice Inc Medicare	$87.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$114.12

COLLAGENASE 30G

Facility OP

$155.00

Hospital Charge Code	41647170
Hospital Revenue Code	250
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$124.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$77.50
Rate for Payer: Aetna Government	$77.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$124.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$105.40
Rate for Payer: Group Health Inc Commercial	$77.50
Rate for Payer: Group Health Inc Medicare	$54.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.75

COLLAGENASE 30G

Facility OP

$155.00

Hospital Charge Code	41657170
Hospital Revenue Code	250
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$124.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$77.50
Rate for Payer: Aetna Government	$77.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$124.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$105.40
Rate for Payer: Group Health Inc Commercial	$77.50
Rate for Payer: Group Health Inc Medicare	$54.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.75

COLLAGENASE OINT 15 GRAMS

Facility OP

$52.00

Hospital Charge Code	41643621
Hospital Revenue Code	250
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$41.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.00
Rate for Payer: Aetna Government	$26.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.36
Rate for Payer: Group Health Inc Commercial	$26.00
Rate for Payer: Group Health Inc Medicare	$18.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.00
Rate for Payer: Hamaspik Choice Inc Medicare	$26.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.80

COLLAGENASE OINT 15 GRAMS

Facility OP

$52.00

Hospital Charge Code	41653621
Hospital Revenue Code	250
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$41.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.00
Rate for Payer: Aetna Government	$26.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.36
Rate for Payer: Group Health Inc Commercial	$26.00
Rate for Payer: Group Health Inc Medicare	$18.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.00
Rate for Payer: Hamaspik Choice Inc Medicare	$26.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.80

COLLAGENASE OINT 30 GRAMS

Facility OP

$155.00

Hospital Charge Code	41645596
Hospital Revenue Code	250
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$124.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$77.50
Rate for Payer: Aetna Government	$77.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$124.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$105.40
Rate for Payer: Group Health Inc Commercial	$77.50
Rate for Payer: Group Health Inc Medicare	$54.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.75

COLLAGENASE OINT 30 GRAMS

Facility OP

$155.00

Hospital Charge Code	41655596
Hospital Revenue Code	250
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$124.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$77.50
Rate for Payer: Aetna Government	$77.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$124.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$105.40
Rate for Payer: Group Health Inc Commercial	$77.50
Rate for Payer: Group Health Inc Medicare	$54.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.75

COLLAGEN, PURACOL ULTRA

Facility OP

$45.40

Hospital Charge Code	40201964
Hospital Revenue Code	270
Min. Negotiated Rate	$15.89
Max. Negotiated Rate	$36.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.70
Rate for Payer: Aetna Government	$22.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.87
Rate for Payer: Group Health Inc Commercial	$22.70
Rate for Payer: Group Health Inc Medicare	$15.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.70
Rate for Payer: Hamaspik Choice Inc Medicare	$22.70

COLLAR CERVICAL ASPEN LG

Facility OP

$8.53

Hospital Charge Code	64901896
Hospital Revenue Code	270
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$6.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.26
Rate for Payer: Aetna Government	$4.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.80
Rate for Payer: Group Health Inc Commercial	$4.26
Rate for Payer: Group Health Inc Medicare	$2.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.26
Rate for Payer: Hamaspik Choice Inc Medicare	$4.26

COLLAR CERVICAL ASPEN MED

Facility OP

$8.53

Hospital Charge Code	64901891
Hospital Revenue Code	270
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$6.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.26
Rate for Payer: Aetna Government	$4.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.80
Rate for Payer: Group Health Inc Commercial	$4.26
Rate for Payer: Group Health Inc Medicare	$2.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.26
Rate for Payer: Hamaspik Choice Inc Medicare	$4.26

COLLAR CERVICAL ASPEN REGULAR 3

Facility OP

$75.00

Hospital Charge Code	64901012
Hospital Revenue Code	270
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$60.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.50
Rate for Payer: Aetna Government	$37.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.00
Rate for Payer: Group Health Inc Commercial	$37.50
Rate for Payer: Group Health Inc Medicare	$26.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.50
Rate for Payer: Hamaspik Choice Inc Medicare	$37.50

COLLAR CERVICAL ASPEN SM

Facility OP

$8.53

Hospital Charge Code	64901890
Hospital Revenue Code	270
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$6.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.26
Rate for Payer: Aetna Government	$4.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.80
Rate for Payer: Group Health Inc Commercial	$4.26
Rate for Payer: Group Health Inc Medicare	$2.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.26
Rate for Payer: Hamaspik Choice Inc Medicare	$4.26

COLLAR CERVICAL ASPEN XTALL 4 1/2

Facility OP

$75.00

Hospital Charge Code	64901020
Hospital Revenue Code	270
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$60.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.50
Rate for Payer: Aetna Government	$37.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.00
Rate for Payer: Group Health Inc Commercial	$37.50
Rate for Payer: Group Health Inc Medicare	$26.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.50
Rate for Payer: Hamaspik Choice Inc Medicare	$37.50

COLLAR CERVICAL MIAMI ADV PAD

Facility OP

$103.13

Hospital Charge Code	64901592
Hospital Revenue Code	270
Min. Negotiated Rate	$36.10
Max. Negotiated Rate	$82.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.56
Rate for Payer: Aetna Government	$51.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$82.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$70.13
Rate for Payer: Group Health Inc Commercial	$51.56
Rate for Payer: Group Health Inc Medicare	$36.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.56
Rate for Payer: Hamaspik Choice Inc Medicare	$51.56

COLLAR,CERVICAL,MIAMI J ADV

Facility OP

$84.20

Hospital Charge Code	64901589
Hospital Revenue Code	270
Min. Negotiated Rate	$29.47
Max. Negotiated Rate	$67.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$42.10
Rate for Payer: Aetna Government	$42.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$57.26
Rate for Payer: Group Health Inc Commercial	$42.10
Rate for Payer: Group Health Inc Medicare	$29.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.10
Rate for Payer: Hamaspik Choice Inc Medicare	$42.10

COLLAR,CERVICAL,UNIV,3X22

Facility OP

$10.03

Hospital Charge Code	64902587
Hospital Revenue Code	270
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$8.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.02
Rate for Payer: Aetna Government	$5.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.82
Rate for Payer: Group Health Inc Commercial	$5.02
Rate for Payer: Group Health Inc Medicare	$3.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.02
Rate for Payer: Hamaspik Choice Inc Medicare	$5.02

COLLAR CERVICAL UNIVERSAL

Facility OP

$5.95

Hospital Charge Code	64901282
Hospital Revenue Code	270
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$4.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.98
Rate for Payer: Aetna Government	$2.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.05
Rate for Payer: Group Health Inc Commercial	$2.98
Rate for Payer: Group Health Inc Medicare	$2.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.98
Rate for Payer: Hamaspik Choice Inc Medicare	$2.98

COLLAR STIFF NECK NO NECK IE745

Facility OP

$8.64

Hospital Charge Code	64901518
Hospital Revenue Code	270
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$6.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.32
Rate for Payer: Aetna Government	$4.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.88
Rate for Payer: Group Health Inc Commercial	$4.32
Rate for Payer: Group Health Inc Medicare	$3.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.32
Rate for Payer: Hamaspik Choice Inc Medicare	$4.32

COLLAR STIFF NECK REGULAR IE745

Facility OP

$22.50

Hospital Charge Code	64901521
Hospital Revenue Code	270
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$18.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.25
Rate for Payer: Aetna Government	$11.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.30
Rate for Payer: Group Health Inc Commercial	$11.25
Rate for Payer: Group Health Inc Medicare	$7.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.25
Rate for Payer: Hamaspik Choice Inc Medicare	$11.25

COLLAR STIFF NECK TALL IE745

Facility OP

$22.50

Hospital Charge Code	64901523
Hospital Revenue Code	270
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$18.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.25
Rate for Payer: Aetna Government	$11.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.30
Rate for Payer: Group Health Inc Commercial	$11.25
Rate for Payer: Group Health Inc Medicare	$7.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.25
Rate for Payer: Hamaspik Choice Inc Medicare	$11.25

COLLAR SUPPORT LARGE

Facility OP

$25.53

Hospital Charge Code	64901209
Hospital Revenue Code	270
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$20.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.76
Rate for Payer: Aetna Government	$12.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.36
Rate for Payer: Group Health Inc Commercial	$12.76
Rate for Payer: Group Health Inc Medicare	$8.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.76
Rate for Payer: Hamaspik Choice Inc Medicare	$12.76

COLLAR SUPPORT PEDIATRIC

Facility OP

$22.51

Hospital Charge Code	64901117
Hospital Revenue Code	270
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$18.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.26
Rate for Payer: Aetna Government	$11.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.31
Rate for Payer: Group Health Inc Commercial	$11.26
Rate for Payer: Group Health Inc Medicare	$7.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.26
Rate for Payer: Hamaspik Choice Inc Medicare	$11.26

COLLAR SUPPORT SMALL

Facility OP

$25.79

Hospital Charge Code	64901207
Hospital Revenue Code	270
Min. Negotiated Rate	$9.03
Max. Negotiated Rate	$20.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.90
Rate for Payer: Aetna Government	$12.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.54
Rate for Payer: Group Health Inc Commercial	$12.90
Rate for Payer: Group Health Inc Medicare	$9.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.90
Rate for Payer: Hamaspik Choice Inc Medicare	$12.90

Price Transparency.

All Charges