St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CLAMP ADJUSTABLE SYNTHES

Facility

$640.00

Hospital Charge Code	40200191
Hospital Revenue Code	270
Min. Negotiated Rate	$224.00
Max. Negotiated Rate	$512.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$352.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$320.00
Rate for Payer: Aetna Government	$320.00
Rate for Payer: Brighton Health Commercial	$480.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$512.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$435.20
Rate for Payer: Group Health Inc Commercial	$320.00
Rate for Payer: Group Health Inc Medicare	$224.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$320.00

CLAMP COMBINATION LG MR SAFE

Facility

$1,232.00

Hospital Charge Code	40200192
Hospital Revenue Code	270
Min. Negotiated Rate	$431.20
Max. Negotiated Rate	$985.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$677.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$616.00
Rate for Payer: Aetna Government	$616.00
Rate for Payer: Brighton Health Commercial	$924.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$985.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$837.76
Rate for Payer: Group Health Inc Commercial	$616.00
Rate for Payer: Group Health Inc Medicare	$431.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$616.00
Rate for Payer: Hamaspik Choice Inc Medicare	$616.00

CLAMP,DELTA 3, HOFFMAN

Facility

$2,130.00

Hospital Charge Code	64905540
Hospital Revenue Code	270
Min. Negotiated Rate	$745.50
Max. Negotiated Rate	$1,704.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,171.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,065.00
Rate for Payer: Aetna Government	$1,065.00
Rate for Payer: Brighton Health Commercial	$1,597.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,704.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,448.40
Rate for Payer: Group Health Inc Commercial	$1,065.00
Rate for Payer: Group Health Inc Medicare	$745.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,065.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,065.00

CLAMP EXTERNAL FIXATION 11M

Facility

$2,076.13

Hospital Charge Code	64905538
Hospital Revenue Code	270
Min. Negotiated Rate	$726.65
Max. Negotiated Rate	$1,660.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,141.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,038.06
Rate for Payer: Aetna Government	$1,038.06
Rate for Payer: Brighton Health Commercial	$1,557.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,660.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,411.77
Rate for Payer: Group Health Inc Commercial	$1,038.06
Rate for Payer: Group Health Inc Medicare	$726.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,038.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1,038.06

CLAMP EXTERNAL FIXATION 30M

Facility

$2,335.50

Hospital Charge Code	64905562
Hospital Revenue Code	270
Min. Negotiated Rate	$817.42
Max. Negotiated Rate	$1,868.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,284.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,167.75
Rate for Payer: Aetna Government	$1,167.75
Rate for Payer: Brighton Health Commercial	$1,751.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,868.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,588.14
Rate for Payer: Group Health Inc Commercial	$1,167.75
Rate for Payer: Group Health Inc Medicare	$817.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,167.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,167.75

CLAMP EXTERNAL FIXATION 4.5

Facility

$973.38

Hospital Charge Code	64904526
Hospital Revenue Code	270
Min. Negotiated Rate	$340.68
Max. Negotiated Rate	$778.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$535.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$486.69
Rate for Payer: Aetna Government	$486.69
Rate for Payer: Brighton Health Commercial	$730.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$778.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$661.90
Rate for Payer: Group Health Inc Commercial	$486.69
Rate for Payer: Group Health Inc Medicare	$340.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$486.69
Rate for Payer: Hamaspik Choice Inc Medicare	$486.69

CLAMP EXTERNAL FIXATION MUL

Facility

$1,460.00

Hospital Charge Code	64904518
Hospital Revenue Code	270
Min. Negotiated Rate	$511.00
Max. Negotiated Rate	$1,168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$803.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$730.00
Rate for Payer: Aetna Government	$730.00
Rate for Payer: Brighton Health Commercial	$1,095.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$992.80
Rate for Payer: Group Health Inc Commercial	$730.00
Rate for Payer: Group Health Inc Medicare	$511.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$730.00
Rate for Payer: Hamaspik Choice Inc Medicare	$730.00

CLAMP EXTERNAL FIXATION REP A

Facility

$1,095.00

Hospital Charge Code	64904516
Hospital Revenue Code	270
Min. Negotiated Rate	$383.25
Max. Negotiated Rate	$876.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$602.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$547.50
Rate for Payer: Aetna Government	$547.50
Rate for Payer: Brighton Health Commercial	$821.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$876.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$744.60
Rate for Payer: Group Health Inc Commercial	$547.50
Rate for Payer: Group Health Inc Medicare	$383.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$547.50
Rate for Payer: Hamaspik Choice Inc Medicare	$547.50

CLAMP EXTERNAL FIXATION REP B

Facility

$2,528.50

Hospital Charge Code	64904708
Hospital Revenue Code	270
Min. Negotiated Rate	$884.98
Max. Negotiated Rate	$2,022.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,390.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,264.25
Rate for Payer: Aetna Government	$1,264.25
Rate for Payer: Brighton Health Commercial	$1,896.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,022.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,719.38
Rate for Payer: Group Health Inc Commercial	$1,264.25
Rate for Payer: Group Health Inc Medicare	$884.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,264.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,264.25

CLAMP GOLD/BLUE

Facility

$722.50

Hospital Charge Code	40202171
Hospital Revenue Code	270
Min. Negotiated Rate	$252.88
Max. Negotiated Rate	$578.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$397.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$361.25
Rate for Payer: Aetna Government	$361.25
Rate for Payer: Brighton Health Commercial	$541.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$578.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$491.30
Rate for Payer: Group Health Inc Commercial	$361.25
Rate for Payer: Group Health Inc Medicare	$252.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$361.25
Rate for Payer: Hamaspik Choice Inc Medicare	$361.25

CLAMP LG PIN 6-POSITION

Facility

$966.00

Hospital Charge Code	40200193
Hospital Revenue Code	270
Min. Negotiated Rate	$338.10
Max. Negotiated Rate	$772.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$531.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$483.00
Rate for Payer: Aetna Government	$483.00
Rate for Payer: Brighton Health Commercial	$724.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$772.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$656.88
Rate for Payer: Group Health Inc Commercial	$483.00
Rate for Payer: Group Health Inc Medicare	$338.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$483.00
Rate for Payer: Hamaspik Choice Inc Medicare	$483.00

CLAMP MR SF 30D OUTRIG POST 11MM

Facility

$252.00

Hospital Charge Code	40200194
Hospital Revenue Code	270
Min. Negotiated Rate	$88.20
Max. Negotiated Rate	$201.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$126.00
Rate for Payer: Aetna Government	$126.00
Rate for Payer: Brighton Health Commercial	$189.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$201.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$171.36
Rate for Payer: Group Health Inc Commercial	$126.00
Rate for Payer: Group Health Inc Medicare	$88.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.00
Rate for Payer: Hamaspik Choice Inc Medicare	$126.00

CLAMP MULTI-PIN 6 POSIT MR SAFE

Facility

$1,402.00

Hospital Charge Code	40200195
Hospital Revenue Code	270
Min. Negotiated Rate	$490.70
Max. Negotiated Rate	$1,121.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$771.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$701.00
Rate for Payer: Aetna Government	$701.00
Rate for Payer: Brighton Health Commercial	$1,051.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,121.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$953.36
Rate for Payer: Group Health Inc Commercial	$701.00
Rate for Payer: Group Health Inc Medicare	$490.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$701.00

CLAMP PIN/ROD H2 1.5-2/3

Facility

$1,231.75

Hospital Charge Code	64904428
Hospital Revenue Code	270
Min. Negotiated Rate	$431.11
Max. Negotiated Rate	$985.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$677.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$615.88
Rate for Payer: Aetna Government	$615.88
Rate for Payer: Brighton Health Commercial	$923.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$985.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$837.59
Rate for Payer: Group Health Inc Commercial	$615.88
Rate for Payer: Group Health Inc Medicare	$431.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$615.88
Rate for Payer: Hamaspik Choice Inc Medicare	$615.88

CLAMP PIN TO ROD

Facility

$805.00

Hospital Charge Code	40200632
Hospital Revenue Code	270
Min. Negotiated Rate	$281.75
Max. Negotiated Rate	$644.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$442.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.50
Rate for Payer: Aetna Government	$402.50
Rate for Payer: Brighton Health Commercial	$603.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$644.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$547.40
Rate for Payer: Group Health Inc Commercial	$402.50
Rate for Payer: Group Health Inc Medicare	$281.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$402.50
Rate for Payer: Hamaspik Choice Inc Medicare	$402.50

CLAMP PLASTIC OCCLUDING

Facility

$1.52

Hospital Charge Code	64901531
Hospital Revenue Code	270
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$1.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Brighton Health Commercial	$1.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.03
Rate for Payer: Group Health Inc Commercial	$0.76
Rate for Payer: Group Health Inc Medicare	$0.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.76
Rate for Payer: Hamaspik Choice Inc Medicare	$0.76

CLAMP PORT OUTLET

Facility

$153.16

Hospital Charge Code	64902223
Hospital Revenue Code	270
Min. Negotiated Rate	$53.61
Max. Negotiated Rate	$122.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$84.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$76.58
Rate for Payer: Aetna Government	$76.58
Rate for Payer: Brighton Health Commercial	$114.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$122.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$104.15
Rate for Payer: Group Health Inc Commercial	$76.58
Rate for Payer: Group Health Inc Medicare	$53.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$76.58
Rate for Payer: Hamaspik Choice Inc Medicare	$76.58

CLAMP RING

Facility

$650.00

Hospital Charge Code	40200633
Hospital Revenue Code	270
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$520.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$357.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$325.00
Rate for Payer: Aetna Government	$325.00
Rate for Payer: Brighton Health Commercial	$487.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$520.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$442.00
Rate for Payer: Group Health Inc Commercial	$325.00
Rate for Payer: Group Health Inc Medicare	$227.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$325.00
Rate for Payer: Hamaspik Choice Inc Medicare	$325.00

CLAMP ROD TO ROD

Facility

$892.00

Hospital Charge Code	40200634
Hospital Revenue Code	270
Min. Negotiated Rate	$312.20
Max. Negotiated Rate	$713.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$490.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$446.00
Rate for Payer: Aetna Government	$446.00
Rate for Payer: Brighton Health Commercial	$669.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$713.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$606.56
Rate for Payer: Group Health Inc Commercial	$446.00
Rate for Payer: Group Health Inc Medicare	$312.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$446.00
Rate for Payer: Hamaspik Choice Inc Medicare	$446.00

CLAMP RT ANGLE

Facility

$49.00

Hospital Charge Code	40200220
Hospital Revenue Code	270
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$39.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.50
Rate for Payer: Aetna Government	$24.50
Rate for Payer: Brighton Health Commercial	$36.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.32
Rate for Payer: Group Health Inc Commercial	$24.50
Rate for Payer: Group Health Inc Medicare	$17.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.50
Rate for Payer: Hamaspik Choice Inc Medicare	$24.50

CLAMP SCREW HOFFMAN SIDE OPEN

Facility

$2.29

Hospital Charge Code	64901764
Hospital Revenue Code	270
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$1.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.14
Rate for Payer: Aetna Government	$1.14
Rate for Payer: Brighton Health Commercial	$1.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.56
Rate for Payer: Group Health Inc Commercial	$1.14
Rate for Payer: Group Health Inc Medicare	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1.14

CLAMP SINGLE

Facility

$410.00

Hospital Charge Code	40200635
Hospital Revenue Code	270
Min. Negotiated Rate	$143.50
Max. Negotiated Rate	$328.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$225.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$205.00
Rate for Payer: Aetna Government	$205.00
Rate for Payer: Brighton Health Commercial	$307.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$328.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$278.80
Rate for Payer: Group Health Inc Commercial	$205.00
Rate for Payer: Group Health Inc Medicare	$143.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$205.00
Rate for Payer: Hamaspik Choice Inc Medicare	$205.00

CLAMP,UMBILICAL CORD,DBL GRIP,ST

Facility

$2.73

Hospital Charge Code	64903016
Hospital Revenue Code	270
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$2.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.36
Rate for Payer: Aetna Government	$1.36
Rate for Payer: Brighton Health Commercial	$2.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.86
Rate for Payer: Group Health Inc Commercial	$1.36
Rate for Payer: Group Health Inc Medicare	$0.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.36
Rate for Payer: Hamaspik Choice Inc Medicare	$1.36

CLAMP VASCULAR #37-1071

Facility

$163.72

Hospital Charge Code	40200443
Hospital Revenue Code	270
Min. Negotiated Rate	$57.30
Max. Negotiated Rate	$130.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$81.86
Rate for Payer: Aetna Government	$81.86
Rate for Payer: Brighton Health Commercial	$122.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$130.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$111.33
Rate for Payer: Group Health Inc Commercial	$81.86
Rate for Payer: Group Health Inc Medicare	$57.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.86
Rate for Payer: Hamaspik Choice Inc Medicare	$81.86

CLARITHROMYCIN 125 MG/5 ML SUSP

Facility

$0.76

Hospital Charge Code	41651428
Hospital Revenue Code	250
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.38
Rate for Payer: Aetna Government	$0.38
Rate for Payer: Brighton Health Commercial	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.52
Rate for Payer: Group Health Inc Commercial	$0.38
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.38
Rate for Payer: Hamaspik Choice Inc Medicare	$0.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.49

Know your out-of-pocket cost for care.

All Charges