St. Barnabas Hospital

All Charges

Charge

Type

Price

FL BARIUM SWALLOW FOR F.B.

Facility OP

$551.90

Service Code	HCPCS 74210 TC
Hospital Charge Code	41102498
Hospital Revenue Code	320
Min. Negotiated Rate	$77.22
Max. Negotiated Rate	$441.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$303.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.95
Rate for Payer: Aetna Government	$275.95
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$441.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$375.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$77.22
Rate for Payer: Group Health Inc Commercial	$275.95
Rate for Payer: Group Health Inc Medicare	$193.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.95
Rate for Payer: Hamaspik Choice Inc Medicare	$275.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$85.80

FL CHOLECYSTOGRAM

Facility OP

$551.90

Service Code	HCPCS 74290 TC
Hospital Charge Code	41102108
Hospital Revenue Code	320
Min. Negotiated Rate	$80.18
Max. Negotiated Rate	$441.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$303.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.95
Rate for Payer: Aetna Government	$275.95
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$441.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$375.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$80.18
Rate for Payer: Group Health Inc Commercial	$275.95
Rate for Payer: Group Health Inc Medicare	$193.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.95
Rate for Payer: Hamaspik Choice Inc Medicare	$275.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$89.09

FL CHOLECYSTOGRAM DD

Facility OP

$551.90

Service Code	HCPCS 74290 TC
Hospital Charge Code	41102512
Hospital Revenue Code	320
Min. Negotiated Rate	$80.18
Max. Negotiated Rate	$441.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$303.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.95
Rate for Payer: Aetna Government	$275.95
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$441.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$375.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$80.18
Rate for Payer: Group Health Inc Commercial	$275.95
Rate for Payer: Group Health Inc Medicare	$193.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.95
Rate for Payer: Hamaspik Choice Inc Medicare	$275.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$89.09

FLEET ENEMA

Facility OP

$9.57

Hospital Charge Code	40201815
Hospital Revenue Code	270
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$7.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.78
Rate for Payer: Aetna Government	$4.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.51
Rate for Payer: Group Health Inc Commercial	$4.78
Rate for Payer: Group Health Inc Medicare	$3.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.78
Rate for Payer: Hamaspik Choice Inc Medicare	$4.78

FL ESOPHAGRAM

Facility OP

$551.90

Service Code	HCPCS 74220 TC
Hospital Charge Code	41102106
Hospital Revenue Code	320
Min. Negotiated Rate	$79.06
Max. Negotiated Rate	$441.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$303.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.95
Rate for Payer: Aetna Government	$275.95
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$441.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$375.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$79.06
Rate for Payer: Group Health Inc Commercial	$275.95
Rate for Payer: Group Health Inc Medicare	$193.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.95
Rate for Payer: Hamaspik Choice Inc Medicare	$275.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$87.85

FLEX 60 ARTICULATING

Facility OP

$2,534.60

Hospital Charge Code	64905189
Hospital Revenue Code	270
Min. Negotiated Rate	$887.11
Max. Negotiated Rate	$2,027.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,394.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,267.30
Rate for Payer: Aetna Government	$1,267.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,027.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,723.53
Rate for Payer: Group Health Inc Commercial	$1,267.30
Rate for Payer: Group Health Inc Medicare	$887.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,267.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1,267.30

FLEXCHFLO870

Facility OP

$339.45

Hospital Charge Code	41569813
Hospital Revenue Code	279
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

FLEX GRAFTON DBM 1.5CM X 1.5CM

Facility OP

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	64902001
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$603.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$316.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$287.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$330.62
Rate for Payer: Fidelis Medicare Advantage	$603.75
Rate for Payer: Group Health Inc Commercial	$287.50
Rate for Payer: Group Health Inc Medicare	$201.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$287.50
Rate for Payer: Hamaspik Choice Inc Medicare	$287.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$373.75

FLEX GRAFTON DBM 1.5CM X 1.5CM

Facility IP

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	64902001
Hospital Revenue Code	278
Min. Negotiated Rate	$287.50
Max. Negotiated Rate	$287.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$287.50
Rate for Payer: Hamaspik Choice Inc Medicare	$287.50

FLEXICAIRE M4000 M3

Facility OP

$211.21

Hospital Charge Code	40209118
Hospital Revenue Code	270
Min. Negotiated Rate	$73.92
Max. Negotiated Rate	$168.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$116.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.60
Rate for Payer: Aetna Government	$105.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$143.62
Rate for Payer: Group Health Inc Commercial	$105.60
Rate for Payer: Group Health Inc Medicare	$73.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.60
Rate for Payer: Hamaspik Choice Inc Medicare	$105.60

FLEXI CARE BED

Facility OP

$162.66

Hospital Charge Code	40200922
Hospital Revenue Code	270
Min. Negotiated Rate	$56.93
Max. Negotiated Rate	$130.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$81.33
Rate for Payer: Aetna Government	$81.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$130.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$110.61
Rate for Payer: Group Health Inc Commercial	$81.33
Rate for Payer: Group Health Inc Medicare	$56.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.33
Rate for Payer: Hamaspik Choice Inc Medicare	$81.33

FLEXICARE BED T3000

Facility OP

$124.04

Hospital Charge Code	40209120
Hospital Revenue Code	270
Min. Negotiated Rate	$43.41
Max. Negotiated Rate	$99.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.02
Rate for Payer: Aetna Government	$62.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.35
Rate for Payer: Group Health Inc Commercial	$62.02
Rate for Payer: Group Health Inc Medicare	$43.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.02
Rate for Payer: Hamaspik Choice Inc Medicare	$62.02

FLEXI-SEAL FECAL COLLECTOR

Facility OP

$108.30

Hospital Charge Code	64901975
Hospital Revenue Code	270
Min. Negotiated Rate	$37.90
Max. Negotiated Rate	$86.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$54.15
Rate for Payer: Aetna Government	$54.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.64
Rate for Payer: Group Health Inc Commercial	$54.15
Rate for Payer: Group Health Inc Medicare	$37.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.15
Rate for Payer: Hamaspik Choice Inc Medicare	$54.15

FLEXIVA 365

Facility OP

$792.00

Service Code	HCPCS C1713
Hospital Charge Code	64903011
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$831.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$435.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$396.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$455.40
Rate for Payer: Fidelis Medicare Advantage	$831.60
Rate for Payer: Group Health Inc Commercial	$396.00
Rate for Payer: Group Health Inc Medicare	$277.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$396.00
Rate for Payer: Hamaspik Choice Inc Medicare	$396.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$514.80

FLEXIVA 365

Facility IP

$792.00

Service Code	HCPCS C1713
Hospital Charge Code	64903011
Hospital Revenue Code	278
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$396.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$396.00
Rate for Payer: Hamaspik Choice Inc Medicare	$396.00

FLEXIVA TRAC TIP 200

Facility OP

$1,151.88

Hospital Charge Code	64903013
Hospital Revenue Code	279
Min. Negotiated Rate	$403.16
Max. Negotiated Rate	$921.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$633.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$575.94
Rate for Payer: Aetna Government	$575.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$921.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$783.28
Rate for Payer: Group Health Inc Commercial	$575.94
Rate for Payer: Group Health Inc Medicare	$403.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$575.94
Rate for Payer: Hamaspik Choice Inc Medicare	$575.94

FL G.I. AIR W/O KUB

Facility OP

$551.90

Service Code	HCPCS 74246 TC
Hospital Charge Code	41102504
Hospital Revenue Code	320
Min. Negotiated Rate	$110.48
Max. Negotiated Rate	$441.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$303.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.95
Rate for Payer: Aetna Government	$275.95
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$441.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$375.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$110.48
Rate for Payer: Group Health Inc Commercial	$275.95
Rate for Payer: Group Health Inc Medicare	$193.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.95
Rate for Payer: Hamaspik Choice Inc Medicare	$275.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$122.76

FL G.I. SERIES W/O KUB

Facility OP

$551.90

Service Code	HCPCS 74240 TC
Hospital Charge Code	41102114
Hospital Revenue Code	320
Min. Negotiated Rate	$96.44
Max. Negotiated Rate	$441.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$303.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.95
Rate for Payer: Aetna Government	$275.95
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cash Price	$212.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$441.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$375.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$96.44
Rate for Payer: Group Health Inc Commercial	$275.95
Rate for Payer: Group Health Inc Medicare	$193.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.95
Rate for Payer: Hamaspik Choice Inc Medicare	$275.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$107.16

FLIP CUTTER 10.0 MM

Facility OP

$812.50

Hospital Charge Code	64905993
Hospital Revenue Code	270
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

FLIPCUTTER 10.5

Facility OP

$812.50

Hospital Charge Code	64905946
Hospital Revenue Code	270
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

FLIP CUTTER 11.0 MM

Facility OP

$812.50

Hospital Charge Code	64906030
Hospital Revenue Code	270
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

FLIP CUTTER II 8.5MM

Facility OP

$812.50

Hospital Charge Code	64905348
Hospital Revenue Code	270
Min. Negotiated Rate	$284.38
Max. Negotiated Rate	$650.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$446.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$406.25
Rate for Payer: Aetna Government	$406.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$552.50
Rate for Payer: Group Health Inc Commercial	$406.25
Rate for Payer: Group Health Inc Medicare	$284.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.25
Rate for Payer: Hamaspik Choice Inc Medicare	$406.25

FLOSEAL HEMOSTATIC MATRIX 5ML

Facility OP

$376.12

Hospital Charge Code	40200986
Hospital Revenue Code	270
Min. Negotiated Rate	$131.64
Max. Negotiated Rate	$300.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$188.06
Rate for Payer: Aetna Government	$188.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$300.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$255.76
Rate for Payer: Group Health Inc Commercial	$188.06
Rate for Payer: Group Health Inc Medicare	$131.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$188.06
Rate for Payer: Hamaspik Choice Inc Medicare	$188.06

FLOUROURACIL 500MG/10ML INJ

Facility IP

$3.00

Service Code	HCPCS J9190
Hospital Charge Code	41640748
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

FLOUROURACIL 500MG/10ML INJ

Facility OP

$3.00

Service Code	HCPCS J9190
Hospital Charge Code	41640748
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$3.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.65
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3.13
Rate for Payer: SOMOS Essential	$3.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

Price Transparency.

All Charges