St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CONVALESCENT PLASMA-COVID-19

Facility

$0.01

Service Code	HCPCS P9017
Hospital Charge Code	40708601
Hospital Revenue Code	383
Rate for Payer: Cash Price	$97.05

CONVALESCENT PLASMA-COVID-19

Facility

$0.01

Service Code	HCPCS P9017
Hospital Charge Code	40708601
Hospital Revenue Code	383
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$98.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$97.05
Rate for Payer: Aetna Government	$97.05
Rate for Payer: Affinity Essential Plan 1&2	$67.94
Rate for Payer: Affinity Essential Plan 3&4	$67.94
Rate for Payer: Affinity Medicaid/CHP/HARP	$67.94
Rate for Payer: Brighton Health Commercial	$97.05
Rate for Payer: Cash Price	$97.05
Rate for Payer: Cash Price	$97.05
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$97.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Elderplan Medicare Advantage	$97.05
Rate for Payer: EmblemHealth Commercial	$97.05
Rate for Payer: Fidelis Essential Plan Aliesa	$82.49
Rate for Payer: Fidelis Essential Plan QHP	$86.37
Rate for Payer: Fidelis Medicare Advantage	$97.05
Rate for Payer: Fidelis Qualified Health Plan	$86.37
Rate for Payer: Group Health Inc Commercial	$97.05
Rate for Payer: Group Health Inc Medicare	$97.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$97.05
Rate for Payer: Healthfirst Medicare Advantage	$82.49
Rate for Payer: Healthfirst QHP	$97.05
Rate for Payer: Humana Medicare	$98.99
Rate for Payer: Senior Whole Health Medicare Advantage	$97.05
Rate for Payer: United Healthcare Commercial	$0.01
Rate for Payer: United Healthcare Medicare Advantage	$97.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$97.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$77.64
Rate for Payer: Wellcare Medicare	$87.34

CONVATEC AQUACEL S/D 3.5X10

Facility

$72.10

Hospital Charge Code	40205375
Hospital Revenue Code	270
Min. Negotiated Rate	$25.24
Max. Negotiated Rate	$57.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$36.05
Rate for Payer: Aetna Government	$36.05
Rate for Payer: Brighton Health Commercial	$54.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.03
Rate for Payer: Group Health Inc Commercial	$36.05
Rate for Payer: Group Health Inc Medicare	$25.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.05
Rate for Payer: Hamaspik Choice Inc Medicare	$36.05

CONVATEC G/T LOOP OSTOMY SYSTEM

Facility

$64.14

Hospital Charge Code	40205377
Hospital Revenue Code	270
Min. Negotiated Rate	$22.45
Max. Negotiated Rate	$51.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.07
Rate for Payer: Aetna Government	$32.07
Rate for Payer: Brighton Health Commercial	$48.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.62
Rate for Payer: Group Health Inc Commercial	$32.07
Rate for Payer: Group Health Inc Medicare	$22.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.07
Rate for Payer: Hamaspik Choice Inc Medicare	$32.07

CONVATEV AQUACEL S/D 3.5X14

Facility

$80.34

Hospital Charge Code	40205376
Hospital Revenue Code	270
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$64.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$40.17
Rate for Payer: Aetna Government	$40.17
Rate for Payer: Brighton Health Commercial	$60.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$64.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$54.63
Rate for Payer: Group Health Inc Commercial	$40.17
Rate for Payer: Group Health Inc Medicare	$28.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.17
Rate for Payer: Hamaspik Choice Inc Medicare	$40.17

CONVEX REAMER - 014

Facility

$2,315.00

Hospital Charge Code	64903267
Hospital Revenue Code	270
Min. Negotiated Rate	$810.25
Max. Negotiated Rate	$1,852.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,273.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,157.50
Rate for Payer: Aetna Government	$1,157.50
Rate for Payer: Brighton Health Commercial	$1,736.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,852.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,574.20
Rate for Payer: Group Health Inc Commercial	$1,157.50
Rate for Payer: Group Health Inc Medicare	$810.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,157.50

CONVEX REAMER -016

Facility

$1,852.00

Hospital Charge Code	40005915
Hospital Revenue Code	272
Min. Negotiated Rate	$648.20
Max. Negotiated Rate	$1,481.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,018.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$926.00
Rate for Payer: Aetna Government	$926.00
Rate for Payer: Brighton Health Commercial	$1,389.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,481.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,259.36
Rate for Payer: Group Health Inc Commercial	$926.00
Rate for Payer: Group Health Inc Medicare	$648.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$926.00
Rate for Payer: Hamaspik Choice Inc Medicare	$926.00

CONVEX REAMER -018

Facility

$2,315.00

Hospital Charge Code	64904653
Hospital Revenue Code	270
Min. Negotiated Rate	$810.25
Max. Negotiated Rate	$1,852.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,273.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,157.50
Rate for Payer: Aetna Government	$1,157.50
Rate for Payer: Brighton Health Commercial	$1,736.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,852.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,574.20
Rate for Payer: Group Health Inc Commercial	$1,157.50
Rate for Payer: Group Health Inc Medicare	$810.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,157.50

COOK 10MMX40MMX80CM

Facility

$2,600.00

Hospital Charge Code	40205600
Hospital Revenue Code	270
Min. Negotiated Rate	$910.00
Max. Negotiated Rate	$2,080.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,430.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,300.00
Rate for Payer: Aetna Government	$1,300.00
Rate for Payer: Brighton Health Commercial	$1,950.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,080.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,768.00
Rate for Payer: Group Health Inc Commercial	$1,300.00
Rate for Payer: Group Health Inc Medicare	$910.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,300.00

COOK 10MMX60MMX60CM

Facility

$2,600.00

Hospital Charge Code	40205601
Hospital Revenue Code	270
Min. Negotiated Rate	$910.00
Max. Negotiated Rate	$2,080.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,430.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,300.00
Rate for Payer: Aetna Government	$1,300.00
Rate for Payer: Brighton Health Commercial	$1,950.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,080.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,768.00
Rate for Payer: Group Health Inc Commercial	$1,300.00
Rate for Payer: Group Health Inc Medicare	$910.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,300.00

COOK 10MMX80MMX80CM

Facility

$2,600.00

Hospital Charge Code	40205602
Hospital Revenue Code	270
Min. Negotiated Rate	$910.00
Max. Negotiated Rate	$2,080.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,430.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,300.00
Rate for Payer: Aetna Government	$1,300.00
Rate for Payer: Brighton Health Commercial	$1,950.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,080.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,768.00
Rate for Payer: Group Health Inc Commercial	$1,300.00
Rate for Payer: Group Health Inc Medicare	$910.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,300.00

COOK 4FR INTRDUCER SHEATH

Facility

$249.00

Service Code	HCPCS C1894
Hospital Charge Code	40205843
Hospital Revenue Code	278
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$261.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.82
Rate for Payer: Aetna Government	$0.82
Rate for Payer: Brighton Health Commercial	$149.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$124.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$143.18
Rate for Payer: EmblemHealth Commercial	$124.50
Rate for Payer: Fidelis Medicare Advantage	$261.45
Rate for Payer: Group Health Inc Commercial	$124.50
Rate for Payer: Group Health Inc Medicare	$87.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$124.50
Rate for Payer: Hamaspik Choice Inc Medicare	$124.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$161.85

COOK 4FR INTRDUCER SHEATH

Facility

$249.00

Service Code	HCPCS C1894
Hospital Charge Code	40205843
Hospital Revenue Code	278
Min. Negotiated Rate	$124.50
Max. Negotiated Rate	$124.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$124.50
Rate for Payer: Hamaspik Choice Inc Medicare	$124.50

COOK 6FR INTRODUCER SHEATH

Facility

$132.50

Service Code	HCPCS C1894
Hospital Charge Code	40205844
Hospital Revenue Code	278
Min. Negotiated Rate	$66.25
Max. Negotiated Rate	$66.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.25
Rate for Payer: Hamaspik Choice Inc Medicare	$66.25

COOK 6FR INTRODUCER SHEATH

Facility

$132.50

Service Code	HCPCS C1894
Hospital Charge Code	40205844
Hospital Revenue Code	278
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$139.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$72.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.82
Rate for Payer: Aetna Government	$0.82
Rate for Payer: Brighton Health Commercial	$79.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.19
Rate for Payer: EmblemHealth Commercial	$66.25
Rate for Payer: Fidelis Medicare Advantage	$139.12
Rate for Payer: Group Health Inc Commercial	$66.25
Rate for Payer: Group Health Inc Medicare	$46.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.25
Rate for Payer: Hamaspik Choice Inc Medicare	$66.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$86.12

COOK 9MMX60MMX80CM

Facility

$2,600.00

Hospital Charge Code	40205599
Hospital Revenue Code	270
Min. Negotiated Rate	$910.00
Max. Negotiated Rate	$2,080.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,430.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,300.00
Rate for Payer: Aetna Government	$1,300.00
Rate for Payer: Brighton Health Commercial	$1,950.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,080.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,768.00
Rate for Payer: Group Health Inc Commercial	$1,300.00
Rate for Payer: Group Health Inc Medicare	$910.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,300.00

COOK BALLON CATHETER 35LP

Facility

$420.00

Service Code	HCPCS C1725
Hospital Charge Code	40205841
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

COOK BALLON CATHETER 35LP

Facility

$420.00

Service Code	HCPCS C1725
Hospital Charge Code	40205841
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

COOK CATH 10MMX.035

Facility

$224.00

Service Code	HCPCS C1887
Hospital Charge Code	40208129
Hospital Revenue Code	278
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$112.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.00
Rate for Payer: Hamaspik Choice Inc Medicare	$112.00

COOK CATH 10MMX.035

Facility

$224.00

Service Code	HCPCS C1887
Hospital Charge Code	40208129
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$235.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$134.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.80
Rate for Payer: EmblemHealth Commercial	$112.00
Rate for Payer: Fidelis Medicare Advantage	$235.20
Rate for Payer: Group Health Inc Commercial	$112.00
Rate for Payer: Group Health Inc Medicare	$78.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.00
Rate for Payer: Hamaspik Choice Inc Medicare	$112.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$145.60

COOK CELECT VENA CAVA FILTER SET

Facility

$2,600.00

Service Code	HCPCS C1880
Hospital Charge Code	40205799
Hospital Revenue Code	278
Min. Negotiated Rate	$1,300.00
Max. Negotiated Rate	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,300.00

COOK CELECT VENA CAVA FILTER SET

Facility

$2,600.00

Service Code	HCPCS C1880
Hospital Charge Code	40205799
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$2,730.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,430.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Brighton Health Commercial	$1,560.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,495.00
Rate for Payer: EmblemHealth Commercial	$1,300.00
Rate for Payer: Fidelis Medicare Advantage	$2,730.00
Rate for Payer: Group Health Inc Commercial	$1,300.00
Rate for Payer: Group Health Inc Medicare	$910.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,690.00

COOK CEREBRAL WIRE GUIDE

Facility

$42.00

Hospital Charge Code	40206285
Hospital Revenue Code	270
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$33.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.00
Rate for Payer: Aetna Government	$21.00
Rate for Payer: Brighton Health Commercial	$31.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.56
Rate for Payer: Group Health Inc Commercial	$21.00
Rate for Payer: Group Health Inc Medicare	$14.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.00
Rate for Payer: Hamaspik Choice Inc Medicare	$21.00

COOK G/W 035X180CM

Facility

$43.50

Service Code	HCPCS C1769
Hospital Charge Code	40205846
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.75
Rate for Payer: Hamaspik Choice Inc Medicare	$21.75

COOK G/W 035X180CM

Facility

$43.50

Service Code	HCPCS C1769
Hospital Charge Code	40205846
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$45.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$26.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.01
Rate for Payer: EmblemHealth Commercial	$21.75
Rate for Payer: Fidelis Medicare Advantage	$45.68
Rate for Payer: Group Health Inc Commercial	$21.75
Rate for Payer: Group Health Inc Medicare	$15.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.75
Rate for Payer: Hamaspik Choice Inc Medicare	$21.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.28

Know your out-of-pocket cost for care.

All Charges