St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

FILTER, BACTERIAL

Facility

$545.00

Hospital Charge Code	64903590
Hospital Revenue Code	270
Min. Negotiated Rate	$190.75
Max. Negotiated Rate	$436.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$299.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.50
Rate for Payer: Aetna Government	$272.50
Rate for Payer: Brighton Health Commercial	$408.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$436.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$370.60
Rate for Payer: Group Health Inc Commercial	$272.50
Rate for Payer: Group Health Inc Medicare	$190.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$272.50
Rate for Payer: Hamaspik Choice Inc Medicare	$272.50

FILTER, CONTAINER ROUND 7 1/2

Facility

$0.15

Hospital Charge Code	64903373
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: Group Health Inc Commercial	$0.08
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08
Rate for Payer: Hamaspik Choice Inc Medicare	$0.08

FILTER DCII DISP & RUB MOUTHPC

Facility

$4.72

Hospital Charge Code	64903323
Hospital Revenue Code	270
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$3.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.36
Rate for Payer: Aetna Government	$2.36
Rate for Payer: Brighton Health Commercial	$3.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.21
Rate for Payer: Group Health Inc Commercial	$2.36
Rate for Payer: Group Health Inc Medicare	$1.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36

FILTER,DRAIN REPLACEMENT

Facility

$237.50

Hospital Charge Code	64903856
Hospital Revenue Code	270
Min. Negotiated Rate	$83.12
Max. Negotiated Rate	$190.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.75
Rate for Payer: Aetna Government	$118.75
Rate for Payer: Brighton Health Commercial	$178.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.50
Rate for Payer: Group Health Inc Commercial	$118.75
Rate for Payer: Group Health Inc Medicare	$83.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.75
Rate for Payer: Hamaspik Choice Inc Medicare	$118.75

FILTERED SPEECH TEST

Facility

$101.25

Service Code	HCPCS 92571
Hospital Charge Code	42004506
Hospital Revenue Code	471
Min. Negotiated Rate	$32.47
Max. Negotiated Rate	$158.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.38
Rate for Payer: Aetna Government	$46.38
Rate for Payer: Affinity Essential Plan 1&2	$32.47
Rate for Payer: Affinity Essential Plan 3&4	$32.47
Rate for Payer: Affinity Medicaid/CHP/HARP	$32.47
Rate for Payer: Brighton Health Commercial	$75.94
Rate for Payer: Cash Price	$46.38
Rate for Payer: Cash Price	$46.38
Rate for Payer: Cash Price	$46.38
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$46.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.85
Rate for Payer: Elderplan Medicare Advantage	$46.38
Rate for Payer: EmblemHealth Commercial	$46.38
Rate for Payer: Fidelis Essential Plan Aliesa	$39.42
Rate for Payer: Fidelis Essential Plan QHP	$41.28
Rate for Payer: Fidelis Medicare Advantage	$46.38
Rate for Payer: Fidelis Qualified Health Plan	$41.28
Rate for Payer: Group Health Inc Commercial	$46.38
Rate for Payer: Group Health Inc Medicare	$46.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.62
Rate for Payer: Hamaspik Choice Inc Medicare	$46.38
Rate for Payer: Healthfirst Medicare Advantage	$39.42
Rate for Payer: Healthfirst QHP	$46.38
Rate for Payer: Humana Medicare	$47.31
Rate for Payer: Senior Whole Health Medicare Advantage	$46.38
Rate for Payer: United Healthcare Commercial	$158.00
Rate for Payer: United Healthcare Medicare Advantage	$46.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.38
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37.10
Rate for Payer: Wellcare Medicare	$44.06

FILTERED SPEECH TEST

Facility

$101.25

Service Code	HCPCS 92571
Hospital Charge Code	42004506
Hospital Revenue Code	471
Rate for Payer: Cash Price	$46.38

FILTER FEMORAL CELECT SET W/NAV

Facility

$2,750.00

Hospital Charge Code	64904888
Hospital Revenue Code	270
Min. Negotiated Rate	$962.50
Max. Negotiated Rate	$2,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,512.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,375.00
Rate for Payer: Aetna Government	$1,375.00
Rate for Payer: Brighton Health Commercial	$2,062.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,870.00
Rate for Payer: Group Health Inc Commercial	$1,375.00
Rate for Payer: Group Health Inc Medicare	$962.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,375.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,375.00

FILTER HME TYCO

Facility

$4.91

Hospital Charge Code	64901322
Hospital Revenue Code	270
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$3.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.46
Rate for Payer: Aetna Government	$2.46
Rate for Payer: Brighton Health Commercial	$3.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.34
Rate for Payer: Group Health Inc Commercial	$2.46
Rate for Payer: Group Health Inc Medicare	$1.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.46
Rate for Payer: Hamaspik Choice Inc Medicare	$2.46

FILTER LIPO TRANS FAT

Facility

$190.00

Hospital Charge Code	64906293
Hospital Revenue Code	279
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$152.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$95.00
Rate for Payer: Aetna Government	$95.00
Rate for Payer: Brighton Health Commercial	$142.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$152.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.20
Rate for Payer: Group Health Inc Commercial	$95.00
Rate for Payer: Group Health Inc Medicare	$66.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00

FILTER MEDIA PACK 21000 TRAM

Facility

$515.00

Hospital Charge Code	64902964
Hospital Revenue Code	270
Min. Negotiated Rate	$180.25
Max. Negotiated Rate	$412.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$283.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$257.50
Rate for Payer: Aetna Government	$257.50
Rate for Payer: Brighton Health Commercial	$386.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$412.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$350.20
Rate for Payer: Group Health Inc Commercial	$257.50
Rate for Payer: Group Health Inc Medicare	$180.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$257.50
Rate for Payer: Hamaspik Choice Inc Medicare	$257.50

FILTER,RESPIGUARD 2,GENERAL PURP

Facility

$2.23

Hospital Charge Code	64902203
Hospital Revenue Code	270
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$1.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.12
Rate for Payer: Aetna Government	$1.12
Rate for Payer: Brighton Health Commercial	$1.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.52
Rate for Payer: Group Health Inc Commercial	$1.12
Rate for Payer: Group Health Inc Medicare	$0.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1.12

FILTERS FOR OFP FLUSHING PUMP

Facility

$18.35

Hospital Charge Code	64903514
Hospital Revenue Code	270
Min. Negotiated Rate	$6.42
Max. Negotiated Rate	$14.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.18
Rate for Payer: Aetna Government	$9.18
Rate for Payer: Brighton Health Commercial	$13.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.48
Rate for Payer: Group Health Inc Commercial	$9.18
Rate for Payer: Group Health Inc Medicare	$6.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.18
Rate for Payer: Hamaspik Choice Inc Medicare	$9.18

FILTER SQUARE 9X9 W/INDICATOR

Facility

$0.14

Hospital Charge Code	64905214
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07

FILTER STERIL CONTAIN MINI 9X4

Facility

$0.08

Hospital Charge Code	64903839
Hospital Revenue Code	270
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04

FILTER STERILIZATION 9 X 9

Facility

$0.13

Hospital Charge Code	64903837
Hospital Revenue Code	270
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.09
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07

FILTER STRAW, 1-3/4, 5 MICR

Facility

$0.94

Hospital Charge Code	64906215
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.47
Rate for Payer: Aetna Government	$0.47
Rate for Payer: Brighton Health Commercial	$0.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.64
Rate for Payer: Group Health Inc Commercial	$0.47
Rate for Payer: Group Health Inc Medicare	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.47
Rate for Payer: Hamaspik Choice Inc Medicare	$0.47

FILTER VAC DRAEGER

Facility

$41.44

Hospital Charge Code	64906826
Hospital Revenue Code	270
Min. Negotiated Rate	$14.50
Max. Negotiated Rate	$33.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.72
Rate for Payer: Aetna Government	$20.72
Rate for Payer: Brighton Health Commercial	$31.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.18
Rate for Payer: Group Health Inc Commercial	$20.72
Rate for Payer: Group Health Inc Medicare	$14.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.72
Rate for Payer: Hamaspik Choice Inc Medicare	$20.72

FILTER,VAPOR MANAGEMENT

Facility

$1,212.50

Hospital Charge Code	64903854
Hospital Revenue Code	270
Min. Negotiated Rate	$424.38
Max. Negotiated Rate	$970.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$666.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$606.25
Rate for Payer: Aetna Government	$606.25
Rate for Payer: Brighton Health Commercial	$909.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$970.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$824.50
Rate for Payer: Group Health Inc Commercial	$606.25
Rate for Payer: Group Health Inc Medicare	$424.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$606.25
Rate for Payer: Hamaspik Choice Inc Medicare	$606.25

FILTER VENA CAVA GREENFLD FEMORAL

Facility

$2,265.90

Service Code	HCPCS C1880
Hospital Charge Code	64901089
Hospital Revenue Code	278
Min. Negotiated Rate	$1,132.95
Max. Negotiated Rate	$1,132.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,132.95
Rate for Payer: Hamaspik Choice Inc Medicare	$1,132.95

FILTER VENA CAVA GREENFLD FEMORAL

Facility

$2,265.90

Service Code	HCPCS C1880
Hospital Charge Code	64901089
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$2,379.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,246.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Brighton Health Commercial	$1,359.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,132.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,302.89
Rate for Payer: EmblemHealth Commercial	$1,132.95
Rate for Payer: Fidelis Medicare Advantage	$2,379.20
Rate for Payer: Group Health Inc Commercial	$1,132.95
Rate for Payer: Group Health Inc Medicare	$793.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,132.95
Rate for Payer: Hamaspik Choice Inc Medicare	$1,132.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,472.84

FILTER VENA CAVA PERM TRAPEASE

Facility

$2,380.00

Service Code	HCPCS C1880
Hospital Charge Code	40202360
Hospital Revenue Code	278
Min. Negotiated Rate	$1,190.00
Max. Negotiated Rate	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,190.00

FILTER VENA CAVA PERM TRAPEASE

Facility

$2,380.00

Service Code	HCPCS C1880
Hospital Charge Code	40202360
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$2,499.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,309.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Brighton Health Commercial	$1,428.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,190.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,368.50
Rate for Payer: EmblemHealth Commercial	$1,190.00
Rate for Payer: Fidelis Medicare Advantage	$2,499.00
Rate for Payer: Group Health Inc Commercial	$1,190.00
Rate for Payer: Group Health Inc Medicare	$833.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,190.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,547.00

FILTER VENA CAVA PERM TRAPEASE

Facility

$2,988.00

Service Code	HCPCS C1880
Hospital Charge Code	64901263
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$3,137.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,643.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Brighton Health Commercial	$1,792.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,494.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,718.10
Rate for Payer: EmblemHealth Commercial	$1,494.00
Rate for Payer: Fidelis Medicare Advantage	$3,137.40
Rate for Payer: Group Health Inc Commercial	$1,494.00
Rate for Payer: Group Health Inc Medicare	$1,045.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,494.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,494.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,942.20

FILTER VENA CAVA PERM TRAPEASE

Facility

$2,988.00

Service Code	HCPCS C1880
Hospital Charge Code	64901263
Hospital Revenue Code	278
Min. Negotiated Rate	$1,494.00
Max. Negotiated Rate	$1,494.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,494.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,494.00

FILTER WATER SEDIMENT REPLACE

Facility

$711.47

Hospital Charge Code	64903672
Hospital Revenue Code	270
Min. Negotiated Rate	$249.01
Max. Negotiated Rate	$569.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$391.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$355.74
Rate for Payer: Aetna Government	$355.74
Rate for Payer: Brighton Health Commercial	$533.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$569.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$483.80
Rate for Payer: Group Health Inc Commercial	$355.74
Rate for Payer: Group Health Inc Medicare	$249.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$355.74
Rate for Payer: Hamaspik Choice Inc Medicare	$355.74

Know your out-of-pocket cost for care.

All Charges