St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CORNEAL FB, REMOVAL W/SLIT LAMP

Facility

$330.23

Service Code	HCPCS 65222
Hospital Charge Code	30301998
Hospital Revenue Code	510
Rate for Payer: Cash Price	$147.72

CORNEAL TRANSPLANT

Facility

$11,564.78

Service Code	HCPCS 65710
Hospital Charge Code	40072480
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$8,673.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,044.08
Rate for Payer: Aetna Government	$6,044.08
Rate for Payer: Affinity Essential Plan 1&2	$4,230.86
Rate for Payer: Affinity Essential Plan 3&4	$4,230.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$4,230.86
Rate for Payer: Brighton Health Commercial	$8,673.58
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,044.08
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	$6,044.08
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$5,137.47
Rate for Payer: Fidelis Essential Plan QHP	$5,379.23
Rate for Payer: Fidelis Medicare Advantage	$6,044.08
Rate for Payer: Fidelis Qualified Health Plan	$5,379.23
Rate for Payer: Group Health Inc Commercial	$6,044.08
Rate for Payer: Group Health Inc Medicare	$6,044.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,782.39
Rate for Payer: Hamaspik Choice Inc Medicare	$6,044.08
Rate for Payer: Healthfirst Medicare Advantage	$5,137.47
Rate for Payer: Healthfirst QHP	$6,044.08
Rate for Payer: Humana Medicare	$6,164.96
Rate for Payer: Senior Whole Health Medicare Advantage	$6,044.08
Rate for Payer: United Healthcare Commercial	$2,683.00
Rate for Payer: United Healthcare Medicare Advantage	$6,044.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,044.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4,835.26
Rate for Payer: Wellcare Medicare	$5,741.88

CORNEAL TRANSPLANT

Facility

$11,564.78

Service Code	HCPCS 65710
Hospital Charge Code	40072480
Hospital Revenue Code	360
Rate for Payer: Cash Price	$6,044.08

CORNEA TRANSPLANT BILATERAL

Facility

$11,564.78

Service Code	HCPCS 65750
Hospital Charge Code	40209554
Hospital Revenue Code	360
Rate for Payer: Cash Price	$6,044.08

CORNEA TRANSPLANT BILATERAL

Facility

$11,564.78

Service Code	HCPCS 65750
Hospital Charge Code	40209554
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$8,673.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,044.08
Rate for Payer: Aetna Government	$6,044.08
Rate for Payer: Affinity Essential Plan 1&2	$4,230.86
Rate for Payer: Affinity Essential Plan 3&4	$4,230.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$4,230.86
Rate for Payer: Brighton Health Commercial	$8,673.58
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,044.08
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	$6,044.08
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$5,137.47
Rate for Payer: Fidelis Essential Plan QHP	$5,379.23
Rate for Payer: Fidelis Medicare Advantage	$6,044.08
Rate for Payer: Fidelis Qualified Health Plan	$5,379.23
Rate for Payer: Group Health Inc Commercial	$6,044.08
Rate for Payer: Group Health Inc Medicare	$6,044.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,782.39
Rate for Payer: Hamaspik Choice Inc Medicare	$6,044.08
Rate for Payer: Healthfirst Medicare Advantage	$5,137.47
Rate for Payer: Healthfirst QHP	$6,044.08
Rate for Payer: Humana Medicare	$6,164.96
Rate for Payer: Senior Whole Health Medicare Advantage	$6,044.08
Rate for Payer: United Healthcare Commercial	$2,683.00
Rate for Payer: United Healthcare Medicare Advantage	$6,044.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,044.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4,835.26
Rate for Payer: Wellcare Medicare	$5,741.88

CORNEA TRANSPLANT UNILATERAL

Facility

$11,564.78

Service Code	HCPCS 65750
Hospital Charge Code	40209553
Hospital Revenue Code	360
Rate for Payer: Cash Price	$6,044.08

CORNEA TRANSPLANT UNILATERAL

Facility

$11,564.78

Service Code	HCPCS 65750
Hospital Charge Code	40209553
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$8,673.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,044.08
Rate for Payer: Aetna Government	$6,044.08
Rate for Payer: Affinity Essential Plan 1&2	$4,230.86
Rate for Payer: Affinity Essential Plan 3&4	$4,230.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$4,230.86
Rate for Payer: Brighton Health Commercial	$8,673.58
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Cash Price	$6,044.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,044.08
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	$6,044.08
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$5,137.47
Rate for Payer: Fidelis Essential Plan QHP	$5,379.23
Rate for Payer: Fidelis Medicare Advantage	$6,044.08
Rate for Payer: Fidelis Qualified Health Plan	$5,379.23
Rate for Payer: Group Health Inc Commercial	$6,044.08
Rate for Payer: Group Health Inc Medicare	$6,044.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,782.39
Rate for Payer: Hamaspik Choice Inc Medicare	$6,044.08
Rate for Payer: Healthfirst Medicare Advantage	$5,137.47
Rate for Payer: Healthfirst QHP	$6,044.08
Rate for Payer: Humana Medicare	$6,164.96
Rate for Payer: Senior Whole Health Medicare Advantage	$6,044.08
Rate for Payer: United Healthcare Commercial	$2,683.00
Rate for Payer: United Healthcare Medicare Advantage	$6,044.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,044.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4,835.26
Rate for Payer: Wellcare Medicare	$5,741.88

COROENT LC 12X11X25 8 DEG

Facility

$9,360.00

Service Code	HCPCS C1713
Hospital Charge Code	64904813
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$9,828.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,148.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5,616.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,680.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,382.00
Rate for Payer: EmblemHealth Commercial	$4,680.00
Rate for Payer: Fidelis Medicare Advantage	$9,828.00
Rate for Payer: Group Health Inc Commercial	$4,680.00
Rate for Payer: Group Health Inc Medicare	$3,276.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,680.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,084.00

COROENT LC 12X11X25 8 DEG

Facility

$9,360.00

Service Code	HCPCS C1713
Hospital Charge Code	64904813
Hospital Revenue Code	278
Min. Negotiated Rate	$4,680.00
Max. Negotiated Rate	$4,680.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,680.00

COROENT LC, 12X9X25 8

Facility

$9,360.00

Service Code	HCPCS C1713
Hospital Charge Code	64905586
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$9,828.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,148.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5,616.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,680.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,382.00
Rate for Payer: EmblemHealth Commercial	$4,680.00
Rate for Payer: Fidelis Medicare Advantage	$9,828.00
Rate for Payer: Group Health Inc Commercial	$4,680.00
Rate for Payer: Group Health Inc Medicare	$3,276.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,680.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,084.00

COROENT LC, 12X9X25 8

Facility

$9,360.00

Service Code	HCPCS C1713
Hospital Charge Code	64905586
Hospital Revenue Code	278
Min. Negotiated Rate	$4,680.00
Max. Negotiated Rate	$4,680.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,680.00

COROENT LI, 10X11X26MM 4D

Facility

$8,980.00

Service Code	HCPCS C1713
Hospital Charge Code	64905419
Hospital Revenue Code	278
Min. Negotiated Rate	$4,490.00
Max. Negotiated Rate	$4,490.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,490.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,490.00

COROENT LI, 10X11X26MM 4D

Facility

$8,980.00

Service Code	HCPCS C1713
Hospital Charge Code	64905419
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$9,429.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,939.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5,388.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,490.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,163.50
Rate for Payer: EmblemHealth Commercial	$4,490.00
Rate for Payer: Fidelis Medicare Advantage	$9,429.00
Rate for Payer: Group Health Inc Commercial	$4,490.00
Rate for Payer: Group Health Inc Medicare	$3,143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,490.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,490.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,837.00

COROENT LI 12X9X20MM 4 DEG

Facility

$19,760.00

Service Code	HCPCS C1713
Hospital Charge Code	64904804
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$20,748.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10,868.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$11,856.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9,880.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$11,362.00
Rate for Payer: EmblemHealth Commercial	$9,880.00
Rate for Payer: Fidelis Medicare Advantage	$20,748.00
Rate for Payer: Group Health Inc Commercial	$9,880.00
Rate for Payer: Group Health Inc Medicare	$6,916.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,880.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9,880.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,844.00

COROENT LI 12X9X20MM 4 DEG

Facility

$19,760.00

Service Code	HCPCS C1713
Hospital Charge Code	64904804
Hospital Revenue Code	278
Min. Negotiated Rate	$9,880.00
Max. Negotiated Rate	$9,880.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,880.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9,880.00

COROENT LI 2X11X26MM 4 DEG

Facility

$8,237.50

Service Code	HCPCS C1713
Hospital Charge Code	64904872
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,649.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,530.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$4,942.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,118.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,736.56
Rate for Payer: EmblemHealth Commercial	$4,118.75
Rate for Payer: Fidelis Medicare Advantage	$8,649.38
Rate for Payer: Group Health Inc Commercial	$4,118.75
Rate for Payer: Group Health Inc Medicare	$2,883.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,118.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,118.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,354.38

COROENT LI 2X11X26MM 4 DEG

Facility

$8,237.50

Service Code	HCPCS C1713
Hospital Charge Code	64904872
Hospital Revenue Code	278
Min. Negotiated Rate	$4,118.75
Max. Negotiated Rate	$4,118.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,118.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,118.75

COROENT LO 10X10X25MM 5 DEG

Facility

$10,920.00

Service Code	HCPCS C1713
Hospital Charge Code	64903718
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$11,466.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,006.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,552.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,460.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,279.00
Rate for Payer: EmblemHealth Commercial	$5,460.00
Rate for Payer: Fidelis Medicare Advantage	$11,466.00
Rate for Payer: Group Health Inc Commercial	$5,460.00
Rate for Payer: Group Health Inc Medicare	$3,822.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,460.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,460.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,098.00

COROENT LO 10X10X25MM 5 DEG

Facility

$10,920.00

Service Code	HCPCS C1713
Hospital Charge Code	64903718
Hospital Revenue Code	278
Min. Negotiated Rate	$5,460.00
Max. Negotiated Rate	$5,460.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,460.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,460.00

COROENT LO 10X10X30 5DEG

Facility

$10,500.00

Hospital Charge Code	64905999
Hospital Revenue Code	270
Min. Negotiated Rate	$3,675.00
Max. Negotiated Rate	$8,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,775.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,250.00
Rate for Payer: Aetna Government	$5,250.00
Rate for Payer: Brighton Health Commercial	$7,875.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,140.00
Rate for Payer: Group Health Inc Commercial	$5,250.00
Rate for Payer: Group Health Inc Medicare	$3,675.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,250.00

COROENT LO 12X10X25MM

Facility

$10,920.00

Service Code	HCPCS C1713
Hospital Charge Code	64903523
Hospital Revenue Code	278
Min. Negotiated Rate	$5,460.00
Max. Negotiated Rate	$5,460.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,460.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,460.00

COROENT LO 12X10X25MM

Facility

$10,920.00

Service Code	HCPCS C1713
Hospital Charge Code	64903523
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$11,466.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,006.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,552.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,460.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,279.00
Rate for Payer: EmblemHealth Commercial	$5,460.00
Rate for Payer: Fidelis Medicare Advantage	$11,466.00
Rate for Payer: Group Health Inc Commercial	$5,460.00
Rate for Payer: Group Health Inc Medicare	$3,822.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,460.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,460.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,098.00

COROENT LO 12X10X30

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903927
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,250.00

COROENT LO 12X10X30

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903927
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$11,025.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,775.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,037.50
Rate for Payer: EmblemHealth Commercial	$5,250.00
Rate for Payer: Fidelis Medicare Advantage	$11,025.00
Rate for Payer: Group Health Inc Commercial	$5,250.00
Rate for Payer: Group Health Inc Medicare	$3,675.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,825.00

COROENT LO 12X10X40MM 5 DG

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64904079
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,250.00

Know your out-of-pocket cost for care.

All Charges