St. Barnabas Hospital

All Charges

Charge

Type

Price

2.2MM THREADEDDRILL GUIDE LCKNGPL

Facility OP

$700.00

Hospital Charge Code	40209518
Hospital Revenue Code	270
Min. Negotiated Rate	$245.00
Max. Negotiated Rate	$560.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$350.00
Rate for Payer: Aetna Government	$350.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$560.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$476.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

23.5X3.1 PIPELLE ENDO SUC CURETTE

Facility OP

$11.00

Hospital Charge Code	40205480
Hospital Revenue Code	270
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$8.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.50
Rate for Payer: Aetna Government	$5.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.48
Rate for Payer: Group Health Inc Commercial	$5.50
Rate for Payer: Group Health Inc Medicare	$3.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5.50

24H STRAIGHT PLT MIDFACE

Facility OP

$796.00

Service Code	HCPCS C1713
Hospital Charge Code	40209829
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$835.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$437.80
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	$398.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$457.70
Rate for Payer: Fidelis Medicare Advantage	$835.80
Rate for Payer: Group Health Inc Commercial	$398.00
Rate for Payer: Group Health Inc Medicare	$278.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.00
Rate for Payer: Hamaspik Choice Inc Medicare	$398.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$517.40

24H STRAIGHT PLT MIDFACE

Facility IP

$796.00

Service Code	HCPCS C1713
Hospital Charge Code	40209829
Hospital Revenue Code	278
Min. Negotiated Rate	$398.00
Max. Negotiated Rate	$398.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.00
Rate for Payer: Hamaspik Choice Inc Medicare	$398.00

24H STRAIGHT PLT UPPERFACE

Facility IP

$756.00

Service Code	HCPCS C1713
Hospital Charge Code	40209826
Hospital Revenue Code	278
Min. Negotiated Rate	$378.00
Max. Negotiated Rate	$378.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$378.00
Rate for Payer: Hamaspik Choice Inc Medicare	$378.00

24H STRAIGHT PLT UPPERFACE

Facility OP

$756.00

Service Code	HCPCS C1713
Hospital Charge Code	40209826
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$793.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$415.80
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	$378.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$434.70
Rate for Payer: Fidelis Medicare Advantage	$793.80
Rate for Payer: Group Health Inc Commercial	$378.00
Rate for Payer: Group Health Inc Medicare	$264.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$378.00
Rate for Payer: Hamaspik Choice Inc Medicare	$378.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$491.40

24H STRT PLATE UP MALL CNDSD

Facility OP

$874.00

Service Code	HCPCS C1713
Hospital Charge Code	40200593
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$917.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$480.70
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	$437.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$502.55
Rate for Payer: Fidelis Medicare Advantage	$917.70
Rate for Payer: Group Health Inc Commercial	$437.00
Rate for Payer: Group Health Inc Medicare	$305.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.00
Rate for Payer: Hamaspik Choice Inc Medicare	$437.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$568.10

24H STRT PLATE UP MALL CNDSD

Facility IP

$874.00

Service Code	HCPCS C1713
Hospital Charge Code	40200593
Hospital Revenue Code	278
Min. Negotiated Rate	$437.00
Max. Negotiated Rate	$437.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.00
Rate for Payer: Hamaspik Choice Inc Medicare	$437.00

24H STRT PLT MDFC MLBL CNDS

Facility OP

$1,341.00

Service Code	HCPCS C1713
Hospital Charge Code	40209828
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,408.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$737.55
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	$670.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$771.08
Rate for Payer: Fidelis Medicare Advantage	$1,408.05
Rate for Payer: Group Health Inc Commercial	$670.50
Rate for Payer: Group Health Inc Medicare	$469.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$670.50
Rate for Payer: Hamaspik Choice Inc Medicare	$670.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$871.65

24H STRT PLT MDFC MLBL CNDS

Facility IP

$1,341.00

Service Code	HCPCS C1713
Hospital Charge Code	40209828
Hospital Revenue Code	278
Min. Negotiated Rate	$670.50
Max. Negotiated Rate	$670.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$670.50
Rate for Payer: Hamaspik Choice Inc Medicare	$670.50

24H STRT PLT UP MALL CNDSD

Facility IP

$874.00

Service Code	HCPCS C1713
Hospital Charge Code	40209830
Hospital Revenue Code	278
Min. Negotiated Rate	$437.00
Max. Negotiated Rate	$437.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.00
Rate for Payer: Hamaspik Choice Inc Medicare	$437.00

24H STRT PLT UP MALL CNDSD

Facility OP

$874.00

Service Code	HCPCS C1713
Hospital Charge Code	40209830
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$917.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$480.70
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	$437.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$502.55
Rate for Payer: Fidelis Medicare Advantage	$917.70
Rate for Payer: Group Health Inc Commercial	$437.00
Rate for Payer: Group Health Inc Medicare	$305.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.00
Rate for Payer: Hamaspik Choice Inc Medicare	$437.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$568.10

2.4 MATRIX MANDIBLE X 12M

Facility IP

$172.00

Service Code	HCPCS C1713
Hospital Charge Code	40200145
Hospital Revenue Code	278
Min. Negotiated Rate	$86.00
Max. Negotiated Rate	$86.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.00
Rate for Payer: Hamaspik Choice Inc Medicare	$86.00

2.4 MATRIX MANDIBLE X 12M

Facility OP

$172.00

Service Code	HCPCS C1713
Hospital Charge Code	40200145
Hospital Revenue Code	278
Min. Negotiated Rate	$60.20
Max. Negotiated Rate	$180.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.60
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	$86.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$98.90
Rate for Payer: Fidelis Medicare Advantage	$180.60
Rate for Payer: Group Health Inc Commercial	$86.00
Rate for Payer: Group Health Inc Medicare	$60.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.00
Rate for Payer: Hamaspik Choice Inc Medicare	$86.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.80

2.4MM X 100CM TR DROP GD

Facility IP

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40006476
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

2.4MM X 100CM TR DROP GD

Facility OP

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40006476
Hospital Revenue Code	278
Min. Negotiated Rate	$122.00
Max. Negotiated Rate	$365.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.71
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	$174.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.42
Rate for Payer: Fidelis Medicare Advantage	$365.99
Rate for Payer: Group Health Inc Commercial	$174.28
Rate for Payer: Group Health Inc Medicare	$122.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.56

2.4MM X 70CM TEAR DROP GD

Facility OP

$304.06

Service Code	HCPCS C1713
Hospital Charge Code	40006478
Hospital Revenue Code	278
Min. Negotiated Rate	$106.42
Max. Negotiated Rate	$319.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$167.23
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	$152.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$174.83
Rate for Payer: Fidelis Medicare Advantage	$319.26
Rate for Payer: Group Health Inc Commercial	$152.03
Rate for Payer: Group Health Inc Medicare	$106.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$152.03
Rate for Payer: Hamaspik Choice Inc Medicare	$152.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$197.64

2.4MM X 70CM TEAR DROP GD

Facility IP

$304.06

Service Code	HCPCS C1713
Hospital Charge Code	40006478
Hospital Revenue Code	278
Min. Negotiated Rate	$152.03
Max. Negotiated Rate	$152.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$152.03
Rate for Payer: Hamaspik Choice Inc Medicare	$152.03

2.4 X 12 NONLOCK SCREW

Facility IP

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	64906790
Hospital Revenue Code	278
Min. Negotiated Rate	$155.00
Max. Negotiated Rate	$155.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.00
Rate for Payer: Hamaspik Choice Inc Medicare	$155.00

2.4 X 12 NONLOCK SCREW

Facility OP

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	64906790
Hospital Revenue Code	278
Min. Negotiated Rate	$108.50
Max. Negotiated Rate	$325.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$170.50
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	$155.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$178.25
Rate for Payer: Fidelis Medicare Advantage	$325.50
Rate for Payer: Group Health Inc Commercial	$155.00
Rate for Payer: Group Health Inc Medicare	$108.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.00
Rate for Payer: Hamaspik Choice Inc Medicare	$155.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$201.50

2.5% DIANEAL 2L

Facility OP

$40.00

Hospital Charge Code	40200984
Hospital Revenue Code	270
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$32.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.00
Rate for Payer: Aetna Government	$20.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.20
Rate for Payer: Group Health Inc Commercial	$20.00
Rate for Payer: Group Health Inc Medicare	$14.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.00
Rate for Payer: Hamaspik Choice Inc Medicare	$20.00

2.5 DRILL BIT

Facility OP

$155.70

Hospital Charge Code	40202756
Hospital Revenue Code	272
Min. Negotiated Rate	$54.50
Max. Negotiated Rate	$124.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$77.85
Rate for Payer: Aetna Government	$77.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$124.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$105.88
Rate for Payer: Group Health Inc Commercial	$77.85
Rate for Payer: Group Health Inc Medicare	$54.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.85
Rate for Payer: Hamaspik Choice Inc Medicare	$77.85

2.5 LONG DRILL BIT

Facility OP

$174.60

Hospital Charge Code	40202757
Hospital Revenue Code	272
Min. Negotiated Rate	$61.11
Max. Negotiated Rate	$139.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$96.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$87.30
Rate for Payer: Aetna Government	$87.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$139.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$118.73
Rate for Payer: Group Health Inc Commercial	$87.30
Rate for Payer: Group Health Inc Medicare	$61.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.30
Rate for Payer: Hamaspik Choice Inc Medicare	$87.30

2.5MM INSERT FOR 4.3MM CA

Facility OP

$281.82

Hospital Charge Code	40006771
Hospital Revenue Code	272
Min. Negotiated Rate	$98.64
Max. Negotiated Rate	$225.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$155.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$140.91
Rate for Payer: Aetna Government	$140.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.64
Rate for Payer: Group Health Inc Commercial	$140.91
Rate for Payer: Group Health Inc Medicare	$98.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.91
Rate for Payer: Hamaspik Choice Inc Medicare	$140.91

26MM AND 7MM HEAD

Facility IP

$1,570.00

Service Code	HCPCS C1713
Hospital Charge Code	40209831
Hospital Revenue Code	278
Min. Negotiated Rate	$785.00
Max. Negotiated Rate	$785.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$785.00
Rate for Payer: Hamaspik Choice Inc Medicare	$785.00

Price Transparency.

All Charges