St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CONNECTOR BAR

Facility

$1,276.00

Service Code	HCPCS D6920
Hospital Charge Code	42303329
Hospital Revenue Code	361
Min. Negotiated Rate	$638.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,018.19
Rate for Payer: Aetna Government	$1,018.19
Rate for Payer: Affinity Essential Plan 1&2	$712.73
Rate for Payer: Affinity Essential Plan 3&4	$712.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$712.73
Rate for Payer: Brighton Health Commercial	$957.00
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,018.19
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	$1,018.19
Rate for Payer: EmblemHealth Commercial	$1,018.19
Rate for Payer: Fidelis Essential Plan Aliesa	$865.46
Rate for Payer: Fidelis Essential Plan QHP	$906.19
Rate for Payer: Fidelis Medicare Advantage	$1,018.19
Rate for Payer: Fidelis Qualified Health Plan	$906.19
Rate for Payer: Group Health Inc Commercial	$1,018.19
Rate for Payer: Group Health Inc Medicare	$1,018.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$638.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,018.19
Rate for Payer: Healthfirst Medicare Advantage	$865.46
Rate for Payer: Healthfirst QHP	$1,018.19
Rate for Payer: Humana Medicare	$1,038.55
Rate for Payer: Senior Whole Health Medicare Advantage	$1,018.19
Rate for Payer: United Healthcare Medicare Advantage	$1,018.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,018.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$814.55
Rate for Payer: Wellcare Medicare	$967.28

CONNECTOR FOR MANOMETER METAL SET

Facility

$16.53

Hospital Charge Code	64901898
Hospital Revenue Code	270
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$13.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.26
Rate for Payer: Aetna Government	$8.26
Rate for Payer: Brighton Health Commercial	$12.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.24
Rate for Payer: Group Health Inc Commercial	$8.26
Rate for Payer: Group Health Inc Medicare	$5.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.26
Rate for Payer: Hamaspik Choice Inc Medicare	$8.26

CONNECTOR MM TRANS HK SLOTTED

Facility

$662.50

Hospital Charge Code	64904444
Hospital Revenue Code	270
Min. Negotiated Rate	$231.88
Max. Negotiated Rate	$530.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$364.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$331.25
Rate for Payer: Aetna Government	$331.25
Rate for Payer: Brighton Health Commercial	$496.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$530.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$450.50
Rate for Payer: Group Health Inc Commercial	$331.25
Rate for Payer: Group Health Inc Medicare	$231.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$331.25
Rate for Payer: Hamaspik Choice Inc Medicare	$331.25

CONNECTOR MUTLI AXIAL 43-54

Facility

$4,263.15

Hospital Charge Code	64905955
Hospital Revenue Code	270
Min. Negotiated Rate	$1,492.10
Max. Negotiated Rate	$3,410.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,344.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,131.58
Rate for Payer: Aetna Government	$2,131.58
Rate for Payer: Brighton Health Commercial	$3,197.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,410.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,898.94
Rate for Payer: Group Health Inc Commercial	$2,131.58
Rate for Payer: Group Health Inc Medicare	$1,492.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,131.58
Rate for Payer: Hamaspik Choice Inc Medicare	$2,131.58

CONNECTOR, NEEDLE-FREE, ONE-LINK

Facility

$4.92

Hospital Charge Code	64901284
Hospital Revenue Code	270
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$3.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.46
Rate for Payer: Aetna Government	$2.46
Rate for Payer: Brighton Health Commercial	$3.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.35
Rate for Payer: Group Health Inc Commercial	$2.46
Rate for Payer: Group Health Inc Medicare	$1.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.46
Rate for Payer: Hamaspik Choice Inc Medicare	$2.46

CONNECTOR SIDE-SPINE

Facility

$3,570.00

Hospital Charge Code	64907182
Hospital Revenue Code	279
Min. Negotiated Rate	$1,249.50
Max. Negotiated Rate	$2,856.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,963.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,785.00
Rate for Payer: Aetna Government	$1,785.00
Rate for Payer: Brighton Health Commercial	$2,677.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,856.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,427.60
Rate for Payer: Group Health Inc Commercial	$1,785.00
Rate for Payer: Group Health Inc Medicare	$1,249.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,785.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,785.00

CONNECTOR STRAIGHT 1.5MM NYLON

Facility

$197.50

Hospital Charge Code	64904176
Hospital Revenue Code	270
Min. Negotiated Rate	$69.12
Max. Negotiated Rate	$158.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$108.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.75
Rate for Payer: Aetna Government	$98.75
Rate for Payer: Brighton Health Commercial	$148.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$158.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.30
Rate for Payer: Group Health Inc Commercial	$98.75
Rate for Payer: Group Health Inc Medicare	$69.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.75
Rate for Payer: Hamaspik Choice Inc Medicare	$98.75

CONNECTOR VAC Y T.R.A.C.

Facility

$4.65

Hospital Charge Code	64901135
Hospital Revenue Code	270
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$3.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.32
Rate for Payer: Aetna Government	$2.32
Rate for Payer: Brighton Health Commercial	$3.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.16
Rate for Payer: Group Health Inc Commercial	$2.32
Rate for Payer: Group Health Inc Medicare	$1.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.32
Rate for Payer: Hamaspik Choice Inc Medicare	$2.32

CONNECTOR Y-TYPE LARGE

Facility

$101.00

Hospital Charge Code	40200404
Hospital Revenue Code	270
Min. Negotiated Rate	$35.35
Max. Negotiated Rate	$80.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.50
Rate for Payer: Aetna Government	$50.50
Rate for Payer: Brighton Health Commercial	$75.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.68
Rate for Payer: Group Health Inc Commercial	$50.50
Rate for Payer: Group Health Inc Medicare	$35.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.50
Rate for Payer: Hamaspik Choice Inc Medicare	$50.50

CONNECT QUICK MARQUETTE

Facility

$7.98

Hospital Charge Code	64901575
Hospital Revenue Code	270
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$6.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.99
Rate for Payer: Aetna Government	$3.99
Rate for Payer: Brighton Health Commercial	$5.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.43
Rate for Payer: Group Health Inc Commercial	$3.99
Rate for Payer: Group Health Inc Medicare	$2.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.99
Rate for Payer: Hamaspik Choice Inc Medicare	$3.99

CONQUEST40 10X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004770
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$399.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$209.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Brighton Health Commercial	$228.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$218.50
Rate for Payer: EmblemHealth Commercial	$190.00
Rate for Payer: Fidelis Medicare Advantage	$399.00
Rate for Payer: Group Health Inc Commercial	$190.00
Rate for Payer: Group Health Inc Medicare	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$247.00

CONQUEST40 10X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004770
Hospital Revenue Code	278
Min. Negotiated Rate	$190.00
Max. Negotiated Rate	$190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00

CONQUEST40 12X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004771
Hospital Revenue Code	278
Min. Negotiated Rate	$190.00
Max. Negotiated Rate	$190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00

CONQUEST40 12X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004771
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$399.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$209.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Brighton Health Commercial	$228.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$218.50
Rate for Payer: EmblemHealth Commercial	$190.00
Rate for Payer: Fidelis Medicare Advantage	$399.00
Rate for Payer: Group Health Inc Commercial	$190.00
Rate for Payer: Group Health Inc Medicare	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$247.00

CONQUEST40 6X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004767
Hospital Revenue Code	278
Min. Negotiated Rate	$190.00
Max. Negotiated Rate	$190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00

CONQUEST40 6X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004767
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$399.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$209.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Brighton Health Commercial	$228.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$218.50
Rate for Payer: EmblemHealth Commercial	$190.00
Rate for Payer: Fidelis Medicare Advantage	$399.00
Rate for Payer: Group Health Inc Commercial	$190.00
Rate for Payer: Group Health Inc Medicare	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$247.00

CONQUEST40 7X80/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004768
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$399.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$209.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Brighton Health Commercial	$228.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$218.50
Rate for Payer: EmblemHealth Commercial	$190.00
Rate for Payer: Fidelis Medicare Advantage	$399.00
Rate for Payer: Group Health Inc Commercial	$190.00
Rate for Payer: Group Health Inc Medicare	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$247.00

CONQUEST40 7X80/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004768
Hospital Revenue Code	278
Min. Negotiated Rate	$190.00
Max. Negotiated Rate	$190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00

CONQUEST40 8X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004769
Hospital Revenue Code	278
Min. Negotiated Rate	$190.00
Max. Negotiated Rate	$190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00

CONQUEST40 8X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004769
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$399.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$209.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Brighton Health Commercial	$228.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$218.50
Rate for Payer: EmblemHealth Commercial	$190.00
Rate for Payer: Fidelis Medicare Advantage	$399.00
Rate for Payer: Group Health Inc Commercial	$190.00
Rate for Payer: Group Health Inc Medicare	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$247.00

CONQUEST 7X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004766
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$399.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$209.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Brighton Health Commercial	$228.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$218.50
Rate for Payer: EmblemHealth Commercial	$190.00
Rate for Payer: Fidelis Medicare Advantage	$399.00
Rate for Payer: Group Health Inc Commercial	$190.00
Rate for Payer: Group Health Inc Medicare	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$247.00

CONQUEST 7X40/75

Facility

$380.00

Service Code	HCPCS C1726
Hospital Charge Code	40004766
Hospital Revenue Code	278
Min. Negotiated Rate	$190.00
Max. Negotiated Rate	$190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00

CONSTRAINED INSERT SZ 5-6 13MM

Facility

$4,700.00

Hospital Charge Code	64905963
Hospital Revenue Code	270
Min. Negotiated Rate	$1,645.00
Max. Negotiated Rate	$3,760.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,585.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,350.00
Rate for Payer: Aetna Government	$2,350.00
Rate for Payer: Brighton Health Commercial	$3,525.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,760.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,196.00
Rate for Payer: Group Health Inc Commercial	$2,350.00
Rate for Payer: Group Health Inc Medicare	$1,645.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,350.00

CONSTRAINED INSERT SZ 5-6 9MM

Facility

$4,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64904861
Hospital Revenue Code	278
Min. Negotiated Rate	$2,350.00
Max. Negotiated Rate	$2,350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,350.00

CONSTRAINED INSERT SZ 5-6 9MM

Facility

$4,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64904861
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,935.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,585.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,820.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,702.50
Rate for Payer: EmblemHealth Commercial	$2,350.00
Rate for Payer: Fidelis Medicare Advantage	$4,935.00
Rate for Payer: Group Health Inc Commercial	$2,350.00
Rate for Payer: Group Health Inc Medicare	$1,645.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,055.00

Know your out-of-pocket cost for care.

All Charges