St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CT WRIST C-

Facility

$339.45

Service Code	HCPCS 73200 TC
Hospital Charge Code	41207438
Hospital Revenue Code	350
Rate for Payer: Cash Price	$127.14

CT WRIST C-/C+

Facility

$551.90

Service Code	HCPCS 73202 TC
Hospital Charge Code	41207440
Hospital Revenue Code	350
Min. Negotiated Rate	$148.73
Max. Negotiated Rate	$668.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$303.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$212.47
Rate for Payer: Aetna Government	$212.47
Rate for Payer: Affinity Essential Plan 1&2	$148.73
Rate for Payer: Affinity Essential Plan 3&4	$148.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$148.73
Rate for Payer: Brighton Health Commercial	$212.47
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cash Price	$212.47
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$212.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$668.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$566.05
Rate for Payer: Elderplan Medicare Advantage	$212.47
Rate for Payer: EmblemHealth Commercial	$148.73
Rate for Payer: Fidelis CHP/HARP/Medicaid	$180.60
Rate for Payer: Fidelis Essential Plan Aliesa	$180.60
Rate for Payer: Fidelis Essential Plan QHP	$189.10
Rate for Payer: Fidelis Medicare Advantage	$212.47
Rate for Payer: Fidelis Qualified Health Plan	$189.10
Rate for Payer: Group Health Inc Commercial	$191.22
Rate for Payer: Group Health Inc Medicare	$191.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.95
Rate for Payer: Hamaspik Choice Inc Medicare	$212.47
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$191.22
Rate for Payer: Healthfirst Medicare Advantage	$212.47
Rate for Payer: Healthfirst QHP	$212.47
Rate for Payer: Humana Medicare	$216.72
Rate for Payer: Senior Whole Health Medicare Advantage	$212.47
Rate for Payer: United Healthcare Commercial	$267.39
Rate for Payer: United Healthcare Medicare Advantage	$212.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$212.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$169.98
Rate for Payer: Wellcare Medicare	$201.85

CT WRIST C-/C+

Facility

$551.90

Service Code	HCPCS 73202 TC
Hospital Charge Code	41207440
Hospital Revenue Code	350
Rate for Payer: Cash Price	$212.47

C TX PATELLAR DISLOCATION,WO ANES

Facility

$653.13

Service Code	HCPCS 27560
Hospital Charge Code	40029100
Hospital Revenue Code	360
Rate for Payer: Cash Price	$272.71

C TX PATELLAR DISLOCATION,WO ANES

Facility

$653.13

Service Code	HCPCS 27560
Hospital Charge Code	40029100
Hospital Revenue Code	360
Min. Negotiated Rate	$190.90
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Affinity Essential Plan 1&2	$190.90
Rate for Payer: Affinity Essential Plan 3&4	$190.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$190.90
Rate for Payer: Brighton Health Commercial	$489.85
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
Rate for Payer: Group Health Inc Commercial	$272.71
Rate for Payer: Group Health Inc Medicare	$272.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$326.56
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst Medicare Advantage	$231.80
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: Humana Medicare	$278.16
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

C TX PATELLAR DISLOCAT. WO ANESTH

Facility

$653.13

Service Code	HCPCS 27560
Hospital Charge Code	30103268
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Affinity Essential Plan 1&2	$190.90
Rate for Payer: Affinity Essential Plan 3&4	$190.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$190.90
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$272.71
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
Rate for Payer: Group Health Inc Commercial	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$326.56
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: Humana Medicare	$278.16
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$272.71
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: United Healthcare Commercial	$569.00
Rate for Payer: United Healthcare Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

C TX PATELLAR DISLOCAT. WO ANESTH

Facility

$653.13

Service Code	HCPCS 27560
Hospital Charge Code	30103268
Hospital Revenue Code	450
Rate for Payer: Cash Price	$272.71

CUBE CNCLLS FRZ DRY 10MM 15CC

Facility

$852.00

Service Code	HCPCS C1713
Hospital Charge Code	64906916
Hospital Revenue Code	278
Min. Negotiated Rate	$426.00
Max. Negotiated Rate	$426.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$426.00
Rate for Payer: Hamaspik Choice Inc Medicare	$426.00

CUBE CNCLLS FRZ DRY 10MM 15CC

Facility

$852.00

Service Code	HCPCS C1713
Hospital Charge Code	64906916
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$894.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$468.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$511.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$426.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$489.90
Rate for Payer: EmblemHealth Commercial	$426.00
Rate for Payer: Fidelis Medicare Advantage	$894.60
Rate for Payer: Group Health Inc Commercial	$426.00
Rate for Payer: Group Health Inc Medicare	$298.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$426.00
Rate for Payer: Hamaspik Choice Inc Medicare	$426.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$553.80

CUBE EXTERNAL FIXATION RANCHO

Facility

$587.13

Service Code	HCPCS C1713
Hospital Charge Code	64904103
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$616.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$352.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$293.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$337.60
Rate for Payer: EmblemHealth Commercial	$293.56
Rate for Payer: Fidelis Medicare Advantage	$616.49
Rate for Payer: Group Health Inc Commercial	$293.56
Rate for Payer: Group Health Inc Medicare	$205.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.56
Rate for Payer: Hamaspik Choice Inc Medicare	$293.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$381.63

CUBE EXTERNAL FIXATION RANCHO

Facility

$587.13

Service Code	HCPCS C1713
Hospital Charge Code	64904103
Hospital Revenue Code	278
Min. Negotiated Rate	$293.56
Max. Negotiated Rate	$293.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.56
Rate for Payer: Hamaspik Choice Inc Medicare	$293.56

CUBE RANCHO 4-HOLE ILIZAROV

Facility

$681.45

Service Code	HCPCS C1713
Hospital Charge Code	64901938
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$715.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$374.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$408.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$340.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$391.83
Rate for Payer: EmblemHealth Commercial	$340.72
Rate for Payer: Fidelis Medicare Advantage	$715.52
Rate for Payer: Group Health Inc Commercial	$340.72
Rate for Payer: Group Health Inc Medicare	$238.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$340.72
Rate for Payer: Hamaspik Choice Inc Medicare	$340.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$442.94

CUBE RANCHO 4-HOLE ILIZAROV

Facility

$681.45

Service Code	HCPCS C1713
Hospital Charge Code	64901938
Hospital Revenue Code	278
Min. Negotiated Rate	$340.72
Max. Negotiated Rate	$340.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$340.72
Rate for Payer: Hamaspik Choice Inc Medicare	$340.72

CUBE RANCHO 5-HOLE S&N

Facility

$752.68

Service Code	HCPCS C1713
Hospital Charge Code	64901285
Hospital Revenue Code	278
Min. Negotiated Rate	$376.34
Max. Negotiated Rate	$376.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$376.34
Rate for Payer: Hamaspik Choice Inc Medicare	$376.34

CUBE RANCHO 5-HOLE S&N

Facility

$752.68

Service Code	HCPCS C1713
Hospital Charge Code	64901285
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$790.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$413.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$451.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$376.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$432.79
Rate for Payer: EmblemHealth Commercial	$376.34
Rate for Payer: Fidelis Medicare Advantage	$790.31
Rate for Payer: Group Health Inc Commercial	$376.34
Rate for Payer: Group Health Inc Medicare	$263.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$376.34
Rate for Payer: Hamaspik Choice Inc Medicare	$376.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$489.24

CUBICIN PED 5MG/ML 500MG -PER 1MG

Facility

$513.00

Service Code	HCPCS J0878
Hospital Charge Code	41647078
Hospital Revenue Code	636
Min. Negotiated Rate	$256.50
Max. Negotiated Rate	$256.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.50
Rate for Payer: Hamaspik Choice Inc Medicare	$256.50

CUBICIN PED 5MG/ML 500MG -PER 1MG

Facility

$513.00

Service Code	HCPCS J0878
Hospital Charge Code	41647078
Hospital Revenue Code	636
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$333.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$282.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$307.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$256.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$294.98
Rate for Payer: Group Health Inc Commercial	$256.50
Rate for Payer: Group Health Inc Medicare	$179.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.50
Rate for Payer: Hamaspik Choice Inc Medicare	$256.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.11
Rate for Payer: SOMOS Essential	$0.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$333.45

CUBICIN PED 5MG/ML 500MG PER 1MG

Facility

$513.00

Service Code	HCPCS J0878
Hospital Charge Code	41657078
Hospital Revenue Code	636
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$333.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$282.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.06
Rate for Payer: Aetna Government	$0.06
Rate for Payer: Brighton Health Commercial	$307.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$256.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$294.98
Rate for Payer: Group Health Inc Commercial	$256.50
Rate for Payer: Group Health Inc Medicare	$179.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.50
Rate for Payer: Hamaspik Choice Inc Medicare	$256.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.11
Rate for Payer: SOMOS Essential	$0.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$333.45

CUBICIN PED 5MG/ML 500MG PER 1MG

Facility

$513.00

Service Code	HCPCS J0878
Hospital Charge Code	41657078
Hospital Revenue Code	636
Min. Negotiated Rate	$256.50
Max. Negotiated Rate	$256.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.50
Rate for Payer: Hamaspik Choice Inc Medicare	$256.50

CUFF

Facility

$11,415.00

Hospital Charge Code	64903857
Hospital Revenue Code	279
Min. Negotiated Rate	$3,995.25
Max. Negotiated Rate	$9,132.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,278.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,707.50
Rate for Payer: Aetna Government	$5,707.50
Rate for Payer: Brighton Health Commercial	$8,561.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9,132.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,762.20
Rate for Payer: Group Health Inc Commercial	$5,707.50
Rate for Payer: Group Health Inc Medicare	$3,995.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,707.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,707.50

CUFF 4.5CM

Facility

$12,487.50

Service Code	HCPCS C1815
Hospital Charge Code	64903561
Hospital Revenue Code	278
Min. Negotiated Rate	$2,453.47
Max. Negotiated Rate	$13,111.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,868.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,453.47
Rate for Payer: Aetna Government	$2,453.47
Rate for Payer: Brighton Health Commercial	$7,492.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,243.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,180.31
Rate for Payer: EmblemHealth Commercial	$6,243.75
Rate for Payer: Fidelis Medicare Advantage	$13,111.88
Rate for Payer: Group Health Inc Commercial	$6,243.75
Rate for Payer: Group Health Inc Medicare	$4,370.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$6,243.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,116.88

CUFF 4.5CM

Facility

$12,487.50

Service Code	HCPCS C1815
Hospital Charge Code	64903561
Hospital Revenue Code	278
Min. Negotiated Rate	$6,243.75
Max. Negotiated Rate	$6,243.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$6,243.75

CUFF BP 1TB/SCW CON LG ADLT WA

Facility

$4.47

Hospital Charge Code	64901175
Hospital Revenue Code	270
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$3.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.24
Rate for Payer: Aetna Government	$2.24
Rate for Payer: Brighton Health Commercial	$3.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.04
Rate for Payer: Group Health Inc Commercial	$2.24
Rate for Payer: Group Health Inc Medicare	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.24
Rate for Payer: Hamaspik Choice Inc Medicare	$2.24

CUFF BP AD MD DS

Facility

$42.90

Hospital Charge Code	64907399
Hospital Revenue Code	270
Min. Negotiated Rate	$15.02
Max. Negotiated Rate	$34.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.45
Rate for Payer: Aetna Government	$21.45
Rate for Payer: Brighton Health Commercial	$32.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.17
Rate for Payer: Group Health Inc Commercial	$21.45
Rate for Payer: Group Health Inc Medicare	$15.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.45
Rate for Payer: Hamaspik Choice Inc Medicare	$21.45

CUFF BP ADULT & BLADDER L/F

Facility

$23.60

Hospital Charge Code	64901748
Hospital Revenue Code	270
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$18.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.80
Rate for Payer: Aetna Government	$11.80
Rate for Payer: Brighton Health Commercial	$17.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.05
Rate for Payer: Group Health Inc Commercial	$11.80
Rate for Payer: Group Health Inc Medicare	$8.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.80
Rate for Payer: Hamaspik Choice Inc Medicare	$11.80

Know your out-of-pocket cost for care.

All Charges