St. Barnabas Hospital

All Charges

Charge

Type

Price

ADAPTER LUER-LOCK PLUG R-2000

Facility OP

$2.20

Hospital Charge Code	40209456
Hospital Revenue Code	270
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$1.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.10
Rate for Payer: Aetna Government	$1.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.50
Rate for Payer: Group Health Inc Commercial	$1.10
Rate for Payer: Group Health Inc Medicare	$0.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1.10

ADAPTER LUER MULTI

Facility OP

$0.50

Hospital Charge Code	64901670
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.34
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25

ADAPTER,NEBULIZER,1000ML

Facility OP

$5.80

Hospital Charge Code	64901862
Hospital Revenue Code	270
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$4.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.90
Rate for Payer: Aetna Government	$2.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.94
Rate for Payer: Group Health Inc Commercial	$2.90
Rate for Payer: Group Health Inc Medicare	$2.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.90
Rate for Payer: Hamaspik Choice Inc Medicare	$2.90

ADAPTER SET BANANA CLIP

Facility OP

$21.93

Hospital Charge Code	64903388
Hospital Revenue Code	270
Min. Negotiated Rate	$7.68
Max. Negotiated Rate	$17.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.96
Rate for Payer: Aetna Government	$10.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.91
Rate for Payer: Group Health Inc Commercial	$10.96
Rate for Payer: Group Health Inc Medicare	$7.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.96
Rate for Payer: Hamaspik Choice Inc Medicare	$10.96

ADAPTER STOMA LOW-PRESS 1-3/4

Facility OP

$1.02

Hospital Charge Code	64901346
Hospital Revenue Code	270
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.51
Rate for Payer: Aetna Government	$0.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.69
Rate for Payer: Group Health Inc Commercial	$0.51
Rate for Payer: Group Health Inc Medicare	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.51
Rate for Payer: Hamaspik Choice Inc Medicare	$0.51

ADAPTER STOMA LOW-PRESS 2-3/4

Facility OP

$1.02

Hospital Charge Code	64901348
Hospital Revenue Code	270
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.51
Rate for Payer: Aetna Government	$0.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.69
Rate for Payer: Group Health Inc Commercial	$0.51
Rate for Payer: Group Health Inc Medicare	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.51
Rate for Payer: Hamaspik Choice Inc Medicare	$0.51

ADAPTER TAPER 42-50MM HD SZ 3MM

Facility OP

$780.00

Service Code	HCPCS C1776
Hospital Charge Code	40206027
Hospital Revenue Code	278
Min. Negotiated Rate	$273.00
Max. Negotiated Rate	$819.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$429.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$390.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$448.50
Rate for Payer: Fidelis Medicare Advantage	$819.00
Rate for Payer: Group Health Inc Commercial	$390.00
Rate for Payer: Group Health Inc Medicare	$273.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$390.00
Rate for Payer: Hamaspik Choice Inc Medicare	$390.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$507.00

ADAPTER TAPER 42-50MM HD SZ 3MM

Facility IP

$780.00

Service Code	HCPCS C1776
Hospital Charge Code	40206027
Hospital Revenue Code	278
Min. Negotiated Rate	$390.00
Max. Negotiated Rate	$390.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$390.00
Rate for Payer: Hamaspik Choice Inc Medicare	$390.00

ADAPTER TRACH AEROSOL DISP 1077

Facility OP

$0.30

Hospital Charge Code	64902235
Hospital Revenue Code	270
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.15
Rate for Payer: Aetna Government	$0.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: Group Health Inc Commercial	$0.15
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15

ADAPTER VIAL 13MM ORA

Facility OP

$1.64

Hospital Charge Code	64901569
Hospital Revenue Code	270
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$1.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.82
Rate for Payer: Aetna Government	$0.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.12
Rate for Payer: Group Health Inc Commercial	$0.82
Rate for Payer: Group Health Inc Medicare	$0.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.82
Rate for Payer: Hamaspik Choice Inc Medicare	$0.82

ADAPTER,VIAL-MATE,F/S DOSE VI,S

Facility OP

$3.61

Hospital Charge Code	64902290
Hospital Revenue Code	270
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$2.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.80
Rate for Payer: Aetna Government	$1.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.45
Rate for Payer: Group Health Inc Commercial	$1.80
Rate for Payer: Group Health Inc Medicare	$1.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.80
Rate for Payer: Hamaspik Choice Inc Medicare	$1.80

ADAPTER WIDE MOUTH UNIV

Facility OP

$0.03

Hospital Charge Code	64903670
Hospital Revenue Code	270
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02

ADAPTER WIRE BOLT

Facility OP

$468.75

Hospital Charge Code	64907388
Hospital Revenue Code	270
Min. Negotiated Rate	$164.06
Max. Negotiated Rate	$375.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$257.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$234.38
Rate for Payer: Aetna Government	$234.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$375.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$318.75
Rate for Payer: Group Health Inc Commercial	$234.38
Rate for Payer: Group Health Inc Medicare	$164.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$234.38
Rate for Payer: Hamaspik Choice Inc Medicare	$234.38

ADAPTIC-DRESSING

Facility OP

$25.52

Hospital Charge Code	40207619
Hospital Revenue Code	270
Min. Negotiated Rate	$8.93
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	$17.35
Rate for Payer: Group Health Inc Commercial	$12.76
Rate for Payer: Group Health Inc Medicare	$8.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.76
Rate for Payer: Hamaspik Choice Inc Medicare	$12.76

ADAPTOR #295

Facility OP

$99.23

Hospital Charge Code	40200309
Hospital Revenue Code	270
Min. Negotiated Rate	$34.73
Max. Negotiated Rate	$79.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$54.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$49.62
Rate for Payer: Aetna Government	$49.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.48
Rate for Payer: Group Health Inc Commercial	$49.62
Rate for Payer: Group Health Inc Medicare	$34.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.62
Rate for Payer: Hamaspik Choice Inc Medicare	$49.62

ADAPTOR HEAD FEMORAL

Facility OP

$460.00

Service Code	HCPCS C1776
Hospital Charge Code	64907109
Hospital Revenue Code	278
Min. Negotiated Rate	$161.00
Max. Negotiated Rate	$483.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$264.50
Rate for Payer: Fidelis Medicare Advantage	$483.00
Rate for Payer: Group Health Inc Commercial	$230.00
Rate for Payer: Group Health Inc Medicare	$161.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$299.00

ADAPTOR HEAD FEMORAL

Facility IP

$460.00

Service Code	HCPCS C1776
Hospital Charge Code	64907109
Hospital Revenue Code	278
Min. Negotiated Rate	$230.00
Max. Negotiated Rate	$230.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00

ADAPTOR UROLOCK

Facility OP

$3.69

Hospital Charge Code	64903083
Hospital Revenue Code	270
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$2.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.84
Rate for Payer: Aetna Government	$1.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.51
Rate for Payer: Group Health Inc Commercial	$1.84
Rate for Payer: Group Health Inc Medicare	$1.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.84
Rate for Payer: Hamaspik Choice Inc Medicare	$1.84

ADAPT PASTE 0.5OZ (14G) TUBE

Facility OP

$29.66

Service Code	HCPCS A4406
Hospital Charge Code	40005171
Hospital Revenue Code	272
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$23.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.48
Rate for Payer: Aetna Government	$3.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.17
Rate for Payer: Group Health Inc Commercial	$14.83
Rate for Payer: Group Health Inc Medicare	$10.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.83
Rate for Payer: Hamaspik Choice Inc Medicare	$14.83

ADAPT POWDER 1OZ(28.3G)PUFF BOTTL

Facility OP

$3.30

Service Code	HCPCS A4371
Hospital Charge Code	40005172
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$2.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.22
Rate for Payer: Aetna Government	$2.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.24
Rate for Payer: Group Health Inc Commercial	$1.65
Rate for Payer: Group Health Inc Medicare	$1.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.65
Rate for Payer: Hamaspik Choice Inc Medicare	$1.65

ADD'1 SEQUEN INFUSION UP TO 1 HR

Facility OP

$183.15

Service Code	HCPCS 96367
Hospital Charge Code	40509867
Hospital Revenue Code	269
Min. Negotiated Rate	$31.22
Max. Negotiated Rate	$146.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$100.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$81.46
Rate for Payer: Aetna Government	$81.46
Rate for Payer: Cash Price	$81.46
Rate for Payer: Cash Price	$81.46
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$81.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$146.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$124.54
Rate for Payer: Elderplan Medicare Advantage	$81.46
Rate for Payer: EmblemHealth Commercial	$81.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31.22
Rate for Payer: Fidelis Essential Plan Aliesa	$69.24
Rate for Payer: Fidelis Essential Plan QHP	$72.50
Rate for Payer: Fidelis Medicare Advantage	$81.46
Rate for Payer: Fidelis Qualified Health Plan	$72.50
Rate for Payer: Group Health Inc Commercial	$81.46
Rate for Payer: Group Health Inc Medicare	$81.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.58
Rate for Payer: Hamaspik Choice Inc Medicare	$81.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34.69
Rate for Payer: Healthfirst Medicare Advantage	$69.24
Rate for Payer: Healthfirst QHP	$81.46
Rate for Payer: Senior Whole Health Medicare Advantage	$81.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$81.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$65.17
Rate for Payer: Wellcare Medicare	$77.39

ADD A LINE SET

Facility OP

$3.90

Hospital Charge Code	40509801
Hospital Revenue Code	260
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$3.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.95
Rate for Payer: Aetna Government	$1.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.65
Rate for Payer: Group Health Inc Commercial	$1.95
Rate for Payer: Group Health Inc Medicare	$1.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.95
Rate for Payer: Hamaspik Choice Inc Medicare	$1.95

ADD CLASP TO EXISTING PARTIAL DEN

Facility OP

$255.00

Service Code	HCPCS D5660
Hospital Charge Code	42301090
Hospital Revenue Code	361
Min. Negotiated Rate	$65.97
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$140.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.97
Rate for Payer: Aetna Government	$65.97
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: Group Health Inc Commercial	$127.50
Rate for Payer: Group Health Inc Medicare	$89.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$127.50
Rate for Payer: Hamaspik Choice Inc Medicare	$127.50

ADDED SKIN LESIONS INJECTION

Facility OP

$529.23

Service Code	HCPCS 11901
Hospital Charge Code	42201730
Hospital Revenue Code	510
Min. Negotiated Rate	$48.77
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$231.52
Rate for Payer: Aetna Government	$231.52
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$231.52
Rate for Payer: Cash Price	$231.52
Rate for Payer: Cash Price	$231.52
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$231.52
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: Elderplan Medicare Advantage	$231.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$48.77
Rate for Payer: Fidelis Essential Plan Aliesa	$196.79
Rate for Payer: Fidelis Essential Plan QHP	$206.05
Rate for Payer: Fidelis Medicare Advantage	$231.52
Rate for Payer: Fidelis Qualified Health Plan	$206.05
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$264.62
Rate for Payer: Hamaspik Choice Inc Medicare	$231.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$54.19
Rate for Payer: Healthfirst Medicare Advantage	$196.79
Rate for Payer: Healthfirst QHP	$231.52
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$231.52
Rate for Payer: Senior Whole Health Medicare Advantage	$231.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$231.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$185.22
Rate for Payer: Wellcare Medicare	$219.94

ADDERALL XR 10MG

Facility OP

$0.02

Hospital Charge Code	41658427
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.02
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: Cigna HMO/Network Benefit Plan/Open Access	$0.02
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	$0.01
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

Price Transparency.

All Charges