St. Barnabas Hospital

All Charges

Charge

Type

Price

AMS 700 ACCESSORY KIT

Facility OP

$1,495.84

Service Code	HCPCS C1813
Hospital Charge Code	40003445
Hospital Revenue Code	278
Min. Negotiated Rate	$523.54
Max. Negotiated Rate	$3,775.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$822.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,775.00
Rate for Payer: Aetna Government	$3,775.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$747.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$860.11
Rate for Payer: Fidelis Medicare Advantage	$1,570.63
Rate for Payer: Group Health Inc Commercial	$747.92
Rate for Payer: Group Health Inc Medicare	$523.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$747.92
Rate for Payer: Hamaspik Choice Inc Medicare	$747.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$972.30

AMS 700 ACCESSORY KIT

Facility IP

$1,495.84

Service Code	HCPCS C1813
Hospital Charge Code	40003445
Hospital Revenue Code	278
Min. Negotiated Rate	$747.92
Max. Negotiated Rate	$747.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$747.92
Rate for Payer: Hamaspik Choice Inc Medicare	$747.92

AMS 700 LGX,MS PMP IZ 15 X 12

Facility IP

$18,827.70

Service Code	HCPCS C1813
Hospital Charge Code	40009265
Hospital Revenue Code	278
Min. Negotiated Rate	$9,413.85
Max. Negotiated Rate	$9,413.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,413.85
Rate for Payer: Hamaspik Choice Inc Medicare	$9,413.85

AMS 700 LGX,MS PMP IZ 15 X 12

Facility OP

$18,827.70

Service Code	HCPCS C1813
Hospital Charge Code	40009265
Hospital Revenue Code	278
Min. Negotiated Rate	$3,775.00
Max. Negotiated Rate	$19,769.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10,355.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,775.00
Rate for Payer: Aetna Government	$3,775.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9,413.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$10,825.93
Rate for Payer: Fidelis Medicare Advantage	$19,769.08
Rate for Payer: Group Health Inc Commercial	$9,413.85
Rate for Payer: Group Health Inc Medicare	$6,589.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,413.85
Rate for Payer: Hamaspik Choice Inc Medicare	$9,413.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,238.00

AMS 700 SPH RESERVOIR W/INH 65ML

Facility IP

$4,615.94

Service Code	HCPCS C1813
Hospital Charge Code	40203429
Hospital Revenue Code	278
Min. Negotiated Rate	$2,307.97
Max. Negotiated Rate	$2,307.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,307.97
Rate for Payer: Hamaspik Choice Inc Medicare	$2,307.97

AMS 700 SPH RESERVOIR W/INH 65ML

Facility OP

$4,615.94

Service Code	HCPCS C1813
Hospital Charge Code	40203429
Hospital Revenue Code	278
Min. Negotiated Rate	$1,615.58
Max. Negotiated Rate	$4,846.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,538.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,775.00
Rate for Payer: Aetna Government	$3,775.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,307.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,654.17
Rate for Payer: Fidelis Medicare Advantage	$4,846.74
Rate for Payer: Group Health Inc Commercial	$2,307.97
Rate for Payer: Group Health Inc Medicare	$1,615.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,307.97
Rate for Payer: Hamaspik Choice Inc Medicare	$2,307.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,000.36

AMS 800 ACCESSORY KIT

Facility OP

$2,273.68

Hospital Charge Code	40009736
Hospital Revenue Code	272
Min. Negotiated Rate	$795.79
Max. Negotiated Rate	$1,818.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,250.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,136.84
Rate for Payer: Aetna Government	$1,136.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,818.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,546.10
Rate for Payer: Group Health Inc Commercial	$1,136.84
Rate for Payer: Group Health Inc Medicare	$795.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,136.84
Rate for Payer: Hamaspik Choice Inc Medicare	$1,136.84

AMS AMS 700 ACCESS

Facility OP

$680.40

Hospital Charge Code	40004045
Hospital Revenue Code	279
Min. Negotiated Rate	$238.14
Max. Negotiated Rate	$544.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$374.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$340.20
Rate for Payer: Aetna Government	$340.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$544.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$462.67
Rate for Payer: Group Health Inc Commercial	$340.20
Rate for Payer: Group Health Inc Medicare	$238.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$340.20
Rate for Payer: Hamaspik Choice Inc Medicare	$340.20

AMS CUFF BLMS 800 CU IZ

Facility OP

$11,411.08

Service Code	HCPCS C1815
Hospital Charge Code	40009739
Hospital Revenue Code	278
Min. Negotiated Rate	$2,453.47
Max. Negotiated Rate	$11,981.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,276.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,453.47
Rate for Payer: Aetna Government	$2,453.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,705.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,561.37
Rate for Payer: Fidelis Medicare Advantage	$11,981.63
Rate for Payer: Group Health Inc Commercial	$5,705.54
Rate for Payer: Group Health Inc Medicare	$3,993.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,705.54
Rate for Payer: Hamaspik Choice Inc Medicare	$5,705.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,417.20

AMS CUFF BLMS 800 CU IZ

Facility IP

$11,411.08

Service Code	HCPCS C1815
Hospital Charge Code	40009739
Hospital Revenue Code	278
Min. Negotiated Rate	$5,705.54
Max. Negotiated Rate	$5,705.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,705.54
Rate for Payer: Hamaspik Choice Inc Medicare	$5,705.54

AMS DURA 11 PENILE PROSTHESIS

Facility OP

$11,690.00

Hospital Charge Code	40200270
Hospital Revenue Code	270
Min. Negotiated Rate	$4,091.50
Max. Negotiated Rate	$9,352.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,429.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,845.00
Rate for Payer: Aetna Government	$5,845.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9,352.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,949.20
Rate for Payer: Group Health Inc Commercial	$5,845.00
Rate for Payer: Group Health Inc Medicare	$4,091.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,845.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,845.00

AMS PENILE PROSTHESIS

Facility IP

$15,482.00

Service Code	HCPCS C1813
Hospital Charge Code	40004043
Hospital Revenue Code	278
Min. Negotiated Rate	$7,741.00
Max. Negotiated Rate	$7,741.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,741.00
Rate for Payer: Hamaspik Choice Inc Medicare	$7,741.00

AMS PENILE PROSTHESIS

Facility OP

$15,482.00

Service Code	HCPCS C1813
Hospital Charge Code	40004043
Hospital Revenue Code	278
Min. Negotiated Rate	$3,775.00
Max. Negotiated Rate	$16,256.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8,515.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,775.00
Rate for Payer: Aetna Government	$3,775.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,741.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$8,902.15
Rate for Payer: Fidelis Medicare Advantage	$16,256.10
Rate for Payer: Group Health Inc Commercial	$7,741.00
Rate for Payer: Group Health Inc Medicare	$5,418.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,741.00
Rate for Payer: Hamaspik Choice Inc Medicare	$7,741.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10,063.30

AMS RESERVOIR CM

Facility OP

$2,622.38

Hospital Charge Code	40004044
Hospital Revenue Code	279
Min. Negotiated Rate	$917.83
Max. Negotiated Rate	$2,097.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,442.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,311.19
Rate for Payer: Aetna Government	$1,311.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,097.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,783.22
Rate for Payer: Group Health Inc Commercial	$1,311.19
Rate for Payer: Group Health Inc Medicare	$917.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,311.19
Rate for Payer: Hamaspik Choice Inc Medicare	$1,311.19

AMS SLING SYSTEM SPARC

Facility IP

$1,990.00

Service Code	HCPCS C1771
Hospital Charge Code	40201024
Hospital Revenue Code	278
Min. Negotiated Rate	$995.00
Max. Negotiated Rate	$995.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$995.00
Rate for Payer: Hamaspik Choice Inc Medicare	$995.00

AMS SLING SYSTEM SPARC

Facility OP

$1,990.00

Service Code	HCPCS C1771
Hospital Charge Code	40201024
Hospital Revenue Code	278
Min. Negotiated Rate	$560.38
Max. Negotiated Rate	$2,089.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,094.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$560.38
Rate for Payer: Aetna Government	$560.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$995.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,144.25
Rate for Payer: Fidelis Medicare Advantage	$2,089.50
Rate for Payer: Group Health Inc Commercial	$995.00
Rate for Payer: Group Health Inc Medicare	$696.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$995.00
Rate for Payer: Hamaspik Choice Inc Medicare	$995.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,293.50

AMS URINARY BLTROL SYST

Facility IP

$5,218.60

Service Code	HCPCS C1815
Hospital Charge Code	40009738
Hospital Revenue Code	278
Min. Negotiated Rate	$2,609.30
Max. Negotiated Rate	$2,609.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,609.30
Rate for Payer: Hamaspik Choice Inc Medicare	$2,609.30

AMS URINARY BLTROL SYST

Facility OP

$5,218.60

Service Code	HCPCS C1815
Hospital Charge Code	40009738
Hospital Revenue Code	278
Min. Negotiated Rate	$1,826.51
Max. Negotiated Rate	$5,479.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,870.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,453.47
Rate for Payer: Aetna Government	$2,453.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,609.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,000.70
Rate for Payer: Fidelis Medicare Advantage	$5,479.53
Rate for Payer: Group Health Inc Commercial	$2,609.30
Rate for Payer: Group Health Inc Medicare	$1,826.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,609.30
Rate for Payer: Hamaspik Choice Inc Medicare	$2,609.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,392.09

AMS URINARY BLTROL SYST INH

Facility OP

$10,991.08

Service Code	HCPCS C1815
Hospital Charge Code	40009737
Hospital Revenue Code	278
Min. Negotiated Rate	$2,453.47
Max. Negotiated Rate	$11,540.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,045.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,453.47
Rate for Payer: Aetna Government	$2,453.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,495.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,319.87
Rate for Payer: Fidelis Medicare Advantage	$11,540.63
Rate for Payer: Group Health Inc Commercial	$5,495.54
Rate for Payer: Group Health Inc Medicare	$3,846.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,495.54
Rate for Payer: Hamaspik Choice Inc Medicare	$5,495.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,144.20

AMS URINARY BLTROL SYST INH

Facility IP

$10,991.08

Service Code	HCPCS C1815
Hospital Charge Code	40009737
Hospital Revenue Code	278
Min. Negotiated Rate	$5,495.54
Max. Negotiated Rate	$5,495.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,495.54
Rate for Payer: Hamaspik Choice Inc Medicare	$5,495.54

AMYLASE 27,000 + LIPASE 5,000 + PROTEASE

Facility OP

$1.11

Hospital Charge Code	41655522
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.56
Rate for Payer: Aetna Government	$0.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.75
Rate for Payer: Group Health Inc Commercial	$0.56
Rate for Payer: Group Health Inc Medicare	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56
Rate for Payer: Hamaspik Choice Inc Medicare	$0.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.72

AMYLASE 27,000 + LIPASE 5,000 + PROTEASE

Facility OP

$1.11

Hospital Charge Code	41645522
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$0.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.56
Rate for Payer: Aetna Government	$0.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.75
Rate for Payer: Group Health Inc Commercial	$0.56
Rate for Payer: Group Health Inc Medicare	$0.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.56
Rate for Payer: Hamaspik Choice Inc Medicare	$0.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.72

AMYLASE 30,000 + LIPASE 8,000 + PROTEASE

Facility OP

$2.00

Hospital Charge Code	41654008
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

AMYLASE 30,000 + LIPASE 8,000 + PROTEASE

Facility OP

$2.00

Hospital Charge Code	41644008
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

AMYLASE FLUID

Facility OP

$16.20

Service Code	HCPCS 82150
Hospital Charge Code	40602425
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$10.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.48
Rate for Payer: Aetna Government	$6.48
Rate for Payer: Cash Price	$6.48
Rate for Payer: Cash Price	$6.48
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.72
Rate for Payer: Elderplan Medicare Advantage	$6.48
Rate for Payer: EmblemHealth Commercial	$6.48
Rate for Payer: Fidelis CHP/HARP/Medicaid	$5.83
Rate for Payer: Fidelis Essential Plan Aliesa	$5.51
Rate for Payer: Fidelis Essential Plan QHP	$5.77
Rate for Payer: Fidelis Medicare Advantage	$6.48
Rate for Payer: Fidelis Qualified Health Plan	$5.77
Rate for Payer: Group Health Inc Commercial	$6.48
Rate for Payer: Group Health Inc Medicare	$6.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.10
Rate for Payer: Hamaspik Choice Inc Medicare	$6.48
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$6.48
Rate for Payer: Healthfirst Medicare Advantage	$6.48
Rate for Payer: Healthfirst QHP	$6.48
Rate for Payer: Senior Whole Health Medicare Advantage	$6.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.48
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.18
Rate for Payer: Wellcare Medicare	$5.83

Price Transparency.

All Charges