St. Barnabas Hospital

All Charges

Charge

Type

Price

DREASSING AQUACEL AG FOAM 6X6

Facility OP

$32.52

Hospital Charge Code	64905728
Hospital Revenue Code	270
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$26.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.26
Rate for Payer: Aetna Government	$16.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.11
Rate for Payer: Group Health Inc Commercial	$16.26
Rate for Payer: Group Health Inc Medicare	$11.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.26
Rate for Payer: Hamaspik Choice Inc Medicare	$16.26

DRESS/DEBRID P THICK BURN S

Facility OP

$529.23

Service Code	HCPCS 16020
Hospital Charge Code	42500455
Hospital Revenue Code	361
Min. Negotiated Rate	$61.62
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: 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: EmblemHealth Commercial	$231.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$61.62
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	$231.52
Rate for Payer: Group Health Inc Medicare	$231.52
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	$68.47
Rate for Payer: Healthfirst Medicare Advantage	$196.79
Rate for Payer: Healthfirst QHP	$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

DRESSING ABTHERA OPEN AB

Facility OP

$920.00

Hospital Charge Code	64901133
Hospital Revenue Code	270
Min. Negotiated Rate	$322.00
Max. Negotiated Rate	$736.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$506.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$460.00
Rate for Payer: Aetna Government	$460.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$736.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$625.60
Rate for Payer: Group Health Inc Commercial	$460.00
Rate for Payer: Group Health Inc Medicare	$322.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$460.00
Rate for Payer: Hamaspik Choice Inc Medicare	$460.00

DRESSING ABTHERA OPEN ABDOMINAL

Facility OP

$901.60

Hospital Charge Code	40201961
Hospital Revenue Code	272
Min. Negotiated Rate	$315.56
Max. Negotiated Rate	$721.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$495.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$450.80
Rate for Payer: Aetna Government	$450.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$721.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$613.09
Rate for Payer: Group Health Inc Commercial	$450.80
Rate for Payer: Group Health Inc Medicare	$315.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.80
Rate for Payer: Hamaspik Choice Inc Medicare	$450.80

DRESSING ALGINATE MAXORB 4X4

Facility OP

$6.90

Hospital Charge Code	40201962
Hospital Revenue Code	272
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$5.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.45
Rate for Payer: Aetna Government	$3.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.69
Rate for Payer: Group Health Inc Commercial	$3.45
Rate for Payer: Group Health Inc Medicare	$2.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.45
Rate for Payer: Hamaspik Choice Inc Medicare	$3.45

DRESSING FOAM

Facility OP

$50.70

Hospital Charge Code	41809544
Hospital Revenue Code	270
Min. Negotiated Rate	$17.74
Max. Negotiated Rate	$40.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.35
Rate for Payer: Aetna Government	$25.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.48
Rate for Payer: Group Health Inc Commercial	$25.35
Rate for Payer: Group Health Inc Medicare	$17.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.35
Rate for Payer: Hamaspik Choice Inc Medicare	$25.35

DRESSING FOAM 4X4

Facility OP

$50.70

Hospital Charge Code	41709544
Hospital Revenue Code	270
Min. Negotiated Rate	$17.74
Max. Negotiated Rate	$40.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.35
Rate for Payer: Aetna Government	$25.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.48
Rate for Payer: Group Health Inc Commercial	$25.35
Rate for Payer: Group Health Inc Medicare	$17.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.35
Rate for Payer: Hamaspik Choice Inc Medicare	$25.35

DRESSING,GEL,SILVASORB,ANTIMICROB

Facility OP

$66.48

Hospital Charge Code	40201967
Hospital Revenue Code	270
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$53.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.24
Rate for Payer: Aetna Government	$33.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.21
Rate for Payer: Group Health Inc Commercial	$33.24
Rate for Payer: Group Health Inc Medicare	$23.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.24
Rate for Payer: Hamaspik Choice Inc Medicare	$33.24

DRESSING, GEL, THERAHONEY

Facility OP

$27.48

Hospital Charge Code	40201965
Hospital Revenue Code	270
Min. Negotiated Rate	$9.62
Max. Negotiated Rate	$21.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.74
Rate for Payer: Aetna Government	$13.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.69
Rate for Payer: Group Health Inc Commercial	$13.74
Rate for Payer: Group Health Inc Medicare	$9.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.74
Rate for Payer: Hamaspik Choice Inc Medicare	$13.74

DRESSING, GLFBR, OPTICELL,AG,4X5

Facility OP

$19.03

Hospital Charge Code	40201968
Hospital Revenue Code	270
Min. Negotiated Rate	$6.66
Max. Negotiated Rate	$15.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.52
Rate for Payer: Aetna Government	$9.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.94
Rate for Payer: Group Health Inc Commercial	$9.52
Rate for Payer: Group Health Inc Medicare	$6.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.52
Rate for Payer: Hamaspik Choice Inc Medicare	$9.52

DRESSING GRANUFOAM VAC LG

Facility OP

$131.63

Hospital Charge Code	64903303
Hospital Revenue Code	270
Min. Negotiated Rate	$46.07
Max. Negotiated Rate	$105.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$72.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.82
Rate for Payer: Aetna Government	$65.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$105.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.51
Rate for Payer: Group Health Inc Commercial	$65.82
Rate for Payer: Group Health Inc Medicare	$46.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.82
Rate for Payer: Hamaspik Choice Inc Medicare	$65.82

DRESSING GRANUFOAM VAC LRG

Facility OP

$145.17

Hospital Charge Code	64903290
Hospital Revenue Code	270
Min. Negotiated Rate	$50.81
Max. Negotiated Rate	$116.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$79.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$72.58
Rate for Payer: Aetna Government	$72.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$116.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$98.72
Rate for Payer: Group Health Inc Commercial	$72.58
Rate for Payer: Group Health Inc Medicare	$50.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.58
Rate for Payer: Hamaspik Choice Inc Medicare	$72.58

DRESSING GRANUFOAM VAC MD

Facility OP

$109.07

Hospital Charge Code	64903292
Hospital Revenue Code	270
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$87.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$54.54
Rate for Payer: Aetna Government	$54.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$87.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$74.17
Rate for Payer: Group Health Inc Commercial	$54.54
Rate for Payer: Group Health Inc Medicare	$38.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.54
Rate for Payer: Hamaspik Choice Inc Medicare	$54.54

DRESSING GRANUFOAM VAC MED

Facility OP

$123.09

Hospital Charge Code	64903302
Hospital Revenue Code	270
Min. Negotiated Rate	$43.08
Max. Negotiated Rate	$98.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$61.54
Rate for Payer: Aetna Government	$61.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$98.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$83.70
Rate for Payer: Group Health Inc Commercial	$61.54
Rate for Payer: Group Health Inc Medicare	$43.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.54
Rate for Payer: Hamaspik Choice Inc Medicare	$61.54

DRESSING GRANUFOAM VAC SM

Facility OP

$95.55

Hospital Charge Code	64903309
Hospital Revenue Code	270
Min. Negotiated Rate	$33.44
Max. Negotiated Rate	$76.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$52.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$47.78
Rate for Payer: Aetna Government	$47.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$76.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.97
Rate for Payer: Group Health Inc Commercial	$47.78
Rate for Payer: Group Health Inc Medicare	$33.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.78
Rate for Payer: Hamaspik Choice Inc Medicare	$47.78

DRESSING HEMOSTAT 1/2

Facility OP

$71.17

Hospital Charge Code	64901885
Hospital Revenue Code	270
Min. Negotiated Rate	$24.91
Max. Negotiated Rate	$56.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.58
Rate for Payer: Aetna Government	$35.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.40
Rate for Payer: Group Health Inc Commercial	$35.58
Rate for Payer: Group Health Inc Medicare	$24.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.58
Rate for Payer: Hamaspik Choice Inc Medicare	$35.58

DRESSING HEMOSTAT 2X14

Facility OP

$243.23

Hospital Charge Code	64901262
Hospital Revenue Code	270
Min. Negotiated Rate	$85.13
Max. Negotiated Rate	$194.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$121.62
Rate for Payer: Aetna Government	$121.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$194.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$165.40
Rate for Payer: Group Health Inc Commercial	$121.62
Rate for Payer: Group Health Inc Medicare	$85.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.62
Rate for Payer: Hamaspik Choice Inc Medicare	$121.62

DRESSING HEMOSTAT 2X3

Facility OP

$133.66

Hospital Charge Code	64901828
Hospital Revenue Code	270
Min. Negotiated Rate	$46.78
Max. Negotiated Rate	$106.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$73.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$66.83
Rate for Payer: Aetna Government	$66.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$106.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$90.89
Rate for Payer: Group Health Inc Commercial	$66.83
Rate for Payer: Group Health Inc Medicare	$46.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.83
Rate for Payer: Hamaspik Choice Inc Medicare	$66.83

DRESSING MERO GEL/SINUS STENT

Facility OP

$280.00

Hospital Charge Code	64903959
Hospital Revenue Code	270
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$224.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$140.00
Rate for Payer: Aetna Government	$140.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$224.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$190.40
Rate for Payer: Group Health Inc Commercial	$140.00
Rate for Payer: Group Health Inc Medicare	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00

DRESSING,QUIKCLOT,HEMO3 (ZME487)

Facility OP

$141.28

Hospital Charge Code	64906447
Hospital Revenue Code	272
Min. Negotiated Rate	$49.45
Max. Negotiated Rate	$113.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.64
Rate for Payer: Aetna Government	$70.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$113.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$96.07
Rate for Payer: Group Health Inc Commercial	$70.64
Rate for Payer: Group Health Inc Medicare	$49.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.64
Rate for Payer: Hamaspik Choice Inc Medicare	$70.64

DRESSINGS

Facility OP

$1.88

Hospital Charge Code	40201229
Hospital Revenue Code	270
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$1.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.94
Rate for Payer: Aetna Government	$0.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.28
Rate for Payer: Group Health Inc Commercial	$0.94
Rate for Payer: Group Health Inc Medicare	$0.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.94
Rate for Payer: Hamaspik Choice Inc Medicare	$0.94

DRESSING SET DISPOSABLE

Facility OP

$21.62

Hospital Charge Code	40191240
Hospital Revenue Code	710
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$17.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.81
Rate for Payer: Aetna Government	$10.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.70
Rate for Payer: Group Health Inc Commercial	$10.81
Rate for Payer: Group Health Inc Medicare	$7.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.81
Rate for Payer: Hamaspik Choice Inc Medicare	$10.81

DRESSING SET, DISPOSABLE

Facility OP

$45.36

Hospital Charge Code	40201240
Hospital Revenue Code	270
Min. Negotiated Rate	$15.88
Max. Negotiated Rate	$36.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.68
Rate for Payer: Aetna Government	$22.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.84
Rate for Payer: Group Health Inc Commercial	$22.68
Rate for Payer: Group Health Inc Medicare	$15.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.68
Rate for Payer: Hamaspik Choice Inc Medicare	$22.68

DRESSING, SHEET, THERAHONEY 4X5

Facility OP

$21.33

Hospital Charge Code	40201966
Hospital Revenue Code	270
Min. Negotiated Rate	$7.47
Max. Negotiated Rate	$17.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.66
Rate for Payer: Aetna Government	$10.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.50
Rate for Payer: Group Health Inc Commercial	$10.66
Rate for Payer: Group Health Inc Medicare	$7.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.66
Rate for Payer: Hamaspik Choice Inc Medicare	$10.66

DRESSINGSPONGE4X3W/FABRICFACING

Facility OP

$0.06

Hospital Charge Code	40209479
Hospital Revenue Code	270
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
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	$0.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.04
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

Price Transparency.

All Charges