St. Barnabas Hospital

All Charges

Charge

Type

Price

DIANEAL 4.25 2LTR BAG

Facility OP

$23.74

Hospital Charge Code	42905282
Hospital Revenue Code	801
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$18.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.87
Rate for Payer: Aetna Government	$11.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.14
Rate for Payer: Group Health Inc Commercial	$11.87
Rate for Payer: Group Health Inc Medicare	$8.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.87
Rate for Payer: Hamaspik Choice Inc Medicare	$11.87

DIANEAL 4.25 3LTR BAG

Facility OP

$31.19

Hospital Charge Code	42905292
Hospital Revenue Code	801
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$24.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.60
Rate for Payer: Aetna Government	$15.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.21
Rate for Payer: Group Health Inc Commercial	$15.60
Rate for Payer: Group Health Inc Medicare	$10.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.60
Rate for Payer: Hamaspik Choice Inc Medicare	$15.60

DIANEAL 4-TYPE SOL ADM. SET

Facility OP

$38.99

Hospital Charge Code	40509822
Hospital Revenue Code	260
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$31.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.50
Rate for Payer: Aetna Government	$19.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$31.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.51
Rate for Payer: Group Health Inc Commercial	$19.50
Rate for Payer: Group Health Inc Medicare	$13.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.50
Rate for Payer: Hamaspik Choice Inc Medicare	$19.50

DIANEAL SOL. 1.5% 2000CC

Facility OP

$46.78

Hospital Charge Code	40509793
Hospital Revenue Code	260
Min. Negotiated Rate	$16.37
Max. Negotiated Rate	$37.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.39
Rate for Payer: Aetna Government	$23.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.81
Rate for Payer: Group Health Inc Commercial	$23.39
Rate for Payer: Group Health Inc Medicare	$16.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.39
Rate for Payer: Hamaspik Choice Inc Medicare	$23.39

DIANEAL SOL. 4.25% 2000CC

Facility OP

$48.91

Hospital Charge Code	40509794
Hospital Revenue Code	260
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$39.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.46
Rate for Payer: Aetna Government	$24.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.26
Rate for Payer: Group Health Inc Commercial	$24.46
Rate for Payer: Group Health Inc Medicare	$17.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46

DIAPER ADULT LARGE ATTENDS

Facility OP

$0.78

Hospital Charge Code	64901140
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.39
Rate for Payer: Aetna Government	$0.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.53
Rate for Payer: Group Health Inc Commercial	$0.39
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39
Rate for Payer: Hamaspik Choice Inc Medicare	$0.39

DIAPER ADULT MEDIUM

Facility OP

$0.59

Hospital Charge Code	64902578
Hospital Revenue Code	270
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.40
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30

DIAPER ADULT XX-LARGE

Facility OP

$1.43

Hospital Charge Code	64901449
Hospital Revenue Code	270
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.72
Rate for Payer: Aetna Government	$0.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.97
Rate for Payer: Group Health Inc Commercial	$0.72
Rate for Payer: Group Health Inc Medicare	$0.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.72
Rate for Payer: Hamaspik Choice Inc Medicare	$0.72

DIAPER PAMPERS NEWBORN

Facility OP

$0.05

Hospital Charge Code	64901735
Hospital Revenue Code	270
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

DIAPER PAMPERS SIZE 4

Facility OP

$0.12

Hospital Charge Code	64902384
Hospital Revenue Code	270
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

DIAPER PAMPERS SIZE 5

Facility OP

$0.27

Hospital Charge Code	64902386
Hospital Revenue Code	270
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.18
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14

DIAPER PAMPERS SZ 1 INFANT

Facility OP

$0.05

Hospital Charge Code	64901921
Hospital Revenue Code	270
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

DIAPER PAMPERS SZ 3 CRAWLER

Facility OP

$0.12

Hospital Charge Code	64901720
Hospital Revenue Code	270
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

DIAPER PREMATURE

Facility OP

$0.05

Hospital Charge Code	64901734
Hospital Revenue Code	270
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.03
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

DIAPER PREMATURE SWADDLER <4LB

Facility OP

$0.17

Hospital Charge Code	64901325
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.12
Rate for Payer: Group Health Inc Commercial	$0.09
Rate for Payer: Group Health Inc Medicare	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09

DIAPER RESTRAINT

Facility OP

$41.82

Hospital Charge Code	40201215
Hospital Revenue Code	270
Min. Negotiated Rate	$14.64
Max. Negotiated Rate	$33.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.91
Rate for Payer: Aetna Government	$20.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.44
Rate for Payer: Group Health Inc Commercial	$20.91
Rate for Payer: Group Health Inc Medicare	$14.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.91
Rate for Payer: Hamaspik Choice Inc Medicare	$20.91

Diapers (Pk)

Facility OP

$51.39

Hospital Charge Code	40201212
Hospital Revenue Code	270
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$41.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.70
Rate for Payer: Aetna Government	$25.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.95
Rate for Payer: Group Health Inc Commercial	$25.70
Rate for Payer: Group Health Inc Medicare	$17.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.70
Rate for Payer: Hamaspik Choice Inc Medicare	$25.70

DIAPHRAGM/CERVICAL CAP FIT

Facility OP

$502.93

Service Code	HCPCS 57170
Hospital Charge Code	30301254
Hospital Revenue Code	510
Min. Negotiated Rate	$54.21
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$230.44
Rate for Payer: Aetna Government	$230.44
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$230.44
Rate for Payer: Cash Price	$230.44
Rate for Payer: Cash Price	$230.44
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$230.44
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	$230.44
Rate for Payer: Fidelis CHP/HARP/Medicaid	$54.21
Rate for Payer: Fidelis Essential Plan Aliesa	$195.87
Rate for Payer: Fidelis Essential Plan QHP	$205.09
Rate for Payer: Fidelis Medicare Advantage	$230.44
Rate for Payer: Fidelis Qualified Health Plan	$205.09
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	$251.46
Rate for Payer: Hamaspik Choice Inc Medicare	$230.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.23
Rate for Payer: Healthfirst Medicare Advantage	$195.87
Rate for Payer: Healthfirst QHP	$230.44
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$230.44
Rate for Payer: Senior Whole Health Medicare Advantage	$230.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.44
Rate for Payer: Wellcare CHP/FHP/Medicaid	$184.35
Rate for Payer: Wellcare Medicare	$218.92

DIAS BP LESS 90

Facility OP

$0.01

Service Code	HCPCS G8754
Hospital Charge Code	30307851
Hospital Revenue Code	510
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$250.00
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: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
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	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

DIAS BP > OR = 90

Facility OP

$0.01

Service Code	HCPCS G8755
Hospital Charge Code	30307871
Hospital Revenue Code	510
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$250.00
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: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
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	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

DIASOL 1.5% DXTRSE 1000 CC

Facility OP

$32.96

Hospital Charge Code	40509832
Hospital Revenue Code	260
Min. Negotiated Rate	$11.54
Max. Negotiated Rate	$26.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.48
Rate for Payer: Aetna Government	$16.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.41
Rate for Payer: Group Health Inc Commercial	$16.48
Rate for Payer: Group Health Inc Medicare	$11.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.48
Rate for Payer: Hamaspik Choice Inc Medicare	$16.48

DIASOL 1.5 DXTRSE 3000CC

Facility OP

$56.70

Hospital Charge Code	40509826
Hospital Revenue Code	260
Min. Negotiated Rate	$19.84
Max. Negotiated Rate	$45.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.35
Rate for Payer: Aetna Government	$28.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.56
Rate for Payer: Group Health Inc Commercial	$28.35
Rate for Payer: Group Health Inc Medicare	$19.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.35
Rate for Payer: Hamaspik Choice Inc Medicare	$28.35

DIASOL 2.5% DXTRSE 1000CC

Facility OP

$33.32

Hospital Charge Code	40509830
Hospital Revenue Code	260
Min. Negotiated Rate	$11.66
Max. Negotiated Rate	$26.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.66
Rate for Payer: Aetna Government	$16.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.66
Rate for Payer: Group Health Inc Commercial	$16.66
Rate for Payer: Group Health Inc Medicare	$11.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.66
Rate for Payer: Hamaspik Choice Inc Medicare	$16.66

DIASOL 2.5% DXTRSE 2000CC

Facility OP

$47.13

Hospital Charge Code	40509831
Hospital Revenue Code	260
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$37.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.56
Rate for Payer: Aetna Government	$23.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.05
Rate for Payer: Group Health Inc Commercial	$23.56
Rate for Payer: Group Health Inc Medicare	$16.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.56
Rate for Payer: Hamaspik Choice Inc Medicare	$23.56

DIASOL 4.25 DXTRSE 3000CC

Facility OP

$59.18

Hospital Charge Code	40509825
Hospital Revenue Code	260
Min. Negotiated Rate	$20.71
Max. Negotiated Rate	$47.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.59
Rate for Payer: Aetna Government	$29.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.24
Rate for Payer: Group Health Inc Commercial	$29.59
Rate for Payer: Group Health Inc Medicare	$20.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.59
Rate for Payer: Hamaspik Choice Inc Medicare	$29.59

Price Transparency.

All Charges