St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

GUIDE CATHET FLUID D

Facility

$1,847.58

Service Code	HCPCS 10030
Hospital Charge Code	41543274
Hospital Revenue Code	361
Rate for Payer: Cash Price	$813.63

GUIDE CATHET FLUID D

Facility

$1,847.58

Service Code	HCPCS 10030
Hospital Charge Code	41543274
Hospital Revenue Code	361
Min. Negotiated Rate	$569.54
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$813.63
Rate for Payer: Aetna Government	$813.63
Rate for Payer: Affinity Essential Plan 1&2	$569.54
Rate for Payer: Affinity Essential Plan 3&4	$569.54
Rate for Payer: Affinity Medicaid/CHP/HARP	$569.54
Rate for Payer: Brighton Health Commercial	$1,385.68
Rate for Payer: Cash Price	$813.63
Rate for Payer: Cash Price	$813.63
Rate for Payer: Cash Price	$813.63
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$813.63
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	$813.63
Rate for Payer: EmblemHealth Commercial	$813.63
Rate for Payer: Fidelis Essential Plan Aliesa	$691.59
Rate for Payer: Fidelis Essential Plan QHP	$724.13
Rate for Payer: Fidelis Medicare Advantage	$813.63
Rate for Payer: Fidelis Qualified Health Plan	$724.13
Rate for Payer: Group Health Inc Commercial	$813.63
Rate for Payer: Group Health Inc Medicare	$813.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$923.79
Rate for Payer: Hamaspik Choice Inc Medicare	$813.63
Rate for Payer: Healthfirst Medicare Advantage	$691.59
Rate for Payer: Healthfirst QHP	$813.63
Rate for Payer: Humana Medicare	$829.90
Rate for Payer: Senior Whole Health Medicare Advantage	$813.63
Rate for Payer: United Healthcare Commercial	$1,188.00
Rate for Payer: United Healthcare Medicare Advantage	$813.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$813.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$650.90
Rate for Payer: Wellcare Medicare	$772.95

GUIDE, CURRING VSP GENIO

Facility

$2,500.00

Service Code	HCPCS C1769
Hospital Charge Code	64906164
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$2,625.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,375.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,437.50
Rate for Payer: EmblemHealth Commercial	$1,250.00
Rate for Payer: Fidelis Medicare Advantage	$2,625.00
Rate for Payer: Group Health Inc Commercial	$1,250.00
Rate for Payer: Group Health Inc Medicare	$875.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,625.00

GUIDE, CURRING VSP GENIO

Facility

$2,500.00

Service Code	HCPCS C1769
Hospital Charge Code	64906164
Hospital Revenue Code	278
Min. Negotiated Rate	$1,250.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,250.00

GUIDED TISSUE REGEN. NON-RESORB

Facility

$375.00

Service Code	HCPCS D4267
Hospital Charge Code	42303310
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,763.60

GUIDED TISSUE REGEN. NON-RESORB

Facility

$375.00

Service Code	HCPCS D4267
Hospital Charge Code	42303310
Hospital Revenue Code	361
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,763.60
Rate for Payer: Aetna Government	$1,763.60
Rate for Payer: Affinity Essential Plan 1&2	$1,234.52
Rate for Payer: Affinity Essential Plan 3&4	$1,234.52
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,234.52
Rate for Payer: Brighton Health Commercial	$281.25
Rate for Payer: Cash Price	$1,763.60
Rate for Payer: Cash Price	$1,763.60
Rate for Payer: Cash Price	$1,763.60
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,763.60
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	$1,763.60
Rate for Payer: EmblemHealth Commercial	$1,763.60
Rate for Payer: Fidelis Essential Plan Aliesa	$1,499.06
Rate for Payer: Fidelis Essential Plan QHP	$1,569.60
Rate for Payer: Fidelis Medicare Advantage	$1,763.60
Rate for Payer: Fidelis Qualified Health Plan	$1,569.60
Rate for Payer: Group Health Inc Commercial	$1,763.60
Rate for Payer: Group Health Inc Medicare	$1,763.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,763.60
Rate for Payer: Healthfirst Medicare Advantage	$1,499.06
Rate for Payer: Healthfirst QHP	$1,763.60
Rate for Payer: Humana Medicare	$1,798.87
Rate for Payer: Senior Whole Health Medicare Advantage	$1,763.60
Rate for Payer: United Healthcare Medicare Advantage	$1,763.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,763.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,410.88
Rate for Payer: Wellcare Medicare	$1,675.42

GUIDED TISSUE REGEN. RESORB BARR.

Facility

$312.50

Service Code	HCPCS D4266
Hospital Charge Code	42303309
Hospital Revenue Code	361
Min. Negotiated Rate	$156.25
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$171.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,763.60
Rate for Payer: Aetna Government	$1,763.60
Rate for Payer: Affinity Essential Plan 1&2	$1,234.52
Rate for Payer: Affinity Essential Plan 3&4	$1,234.52
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,234.52
Rate for Payer: Brighton Health Commercial	$234.38
Rate for Payer: Cash Price	$1,763.60
Rate for Payer: Cash Price	$1,763.60
Rate for Payer: Cash Price	$1,763.60
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,763.60
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	$1,763.60
Rate for Payer: EmblemHealth Commercial	$1,763.60
Rate for Payer: Fidelis Essential Plan Aliesa	$1,499.06
Rate for Payer: Fidelis Essential Plan QHP	$1,569.60
Rate for Payer: Fidelis Medicare Advantage	$1,763.60
Rate for Payer: Fidelis Qualified Health Plan	$1,569.60
Rate for Payer: Group Health Inc Commercial	$1,763.60
Rate for Payer: Group Health Inc Medicare	$1,763.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$156.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,763.60
Rate for Payer: Healthfirst Medicare Advantage	$1,499.06
Rate for Payer: Healthfirst QHP	$1,763.60
Rate for Payer: Humana Medicare	$1,798.87
Rate for Payer: Senior Whole Health Medicare Advantage	$1,763.60
Rate for Payer: United Healthcare Medicare Advantage	$1,763.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,763.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,410.88
Rate for Payer: Wellcare Medicare	$1,675.42

GUIDED TISSUE REGEN. RESORB BARR.

Facility

$312.50

Service Code	HCPCS D4266
Hospital Charge Code	42303309
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,763.60

GUIDE INSERTION REUSE

Facility

$75.00

Hospital Charge Code	64907087
Hospital Revenue Code	270
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$60.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.50
Rate for Payer: Aetna Government	$37.50
Rate for Payer: Brighton Health Commercial	$56.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.00
Rate for Payer: Group Health Inc Commercial	$37.50
Rate for Payer: Group Health Inc Medicare	$26.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.50
Rate for Payer: Hamaspik Choice Inc Medicare	$37.50

GUIDE MARKING VSP, CUTTING

Facility

$1,236.00

Hospital Charge Code	64906480
Hospital Revenue Code	279
Min. Negotiated Rate	$432.60
Max. Negotiated Rate	$988.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$679.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$618.00
Rate for Payer: Aetna Government	$618.00
Rate for Payer: Brighton Health Commercial	$927.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$988.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$840.48
Rate for Payer: Group Health Inc Commercial	$618.00
Rate for Payer: Group Health Inc Medicare	$432.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$618.00
Rate for Payer: Hamaspik Choice Inc Medicare	$618.00

GUIDE NEEDLE 10G

Facility

$17.88

Service Code	HCPCS C1769
Hospital Charge Code	64903901
Hospital Revenue Code	278
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$8.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.94
Rate for Payer: Hamaspik Choice Inc Medicare	$8.94

GUIDE NEEDLE 10G

Facility

$17.88

Service Code	HCPCS C1769
Hospital Charge Code	64903901
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$18.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$10.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.28
Rate for Payer: EmblemHealth Commercial	$8.94
Rate for Payer: Fidelis Medicare Advantage	$18.77
Rate for Payer: Group Health Inc Commercial	$8.94
Rate for Payer: Group Health Inc Medicare	$6.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.94
Rate for Payer: Hamaspik Choice Inc Medicare	$8.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.62

GUIDE NEEDLE ENDOCAVITY W/COVER

Facility

$38.02

Hospital Charge Code	64904521
Hospital Revenue Code	270
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$30.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.01
Rate for Payer: Aetna Government	$19.01
Rate for Payer: Brighton Health Commercial	$28.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.85
Rate for Payer: Group Health Inc Commercial	$19.01
Rate for Payer: Group Health Inc Medicare	$13.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.01
Rate for Payer: Hamaspik Choice Inc Medicare	$19.01

GUIDE PIN POSITIONING TOOL

Facility

$1,072.00

Service Code	HCPCS C1713
Hospital Charge Code	40006139
Hospital Revenue Code	278
Min. Negotiated Rate	$536.00
Max. Negotiated Rate	$536.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.00
Rate for Payer: Hamaspik Choice Inc Medicare	$536.00

GUIDE PIN POSITIONING TOOL

Facility

$1,072.00

Service Code	HCPCS C1713
Hospital Charge Code	40006139
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,125.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$589.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$643.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$536.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$616.40
Rate for Payer: EmblemHealth Commercial	$536.00
Rate for Payer: Fidelis Medicare Advantage	$1,125.60
Rate for Payer: Group Health Inc Commercial	$536.00
Rate for Payer: Group Health Inc Medicare	$375.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.00
Rate for Payer: Hamaspik Choice Inc Medicare	$536.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$696.80

GUIDEPIN SURG 3.2MM DIA 532

Facility

$461.25

Service Code	HCPCS C1769
Hospital Charge Code	64904480
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$484.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$276.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$265.22
Rate for Payer: EmblemHealth Commercial	$230.62
Rate for Payer: Fidelis Medicare Advantage	$484.31
Rate for Payer: Group Health Inc Commercial	$230.62
Rate for Payer: Group Health Inc Medicare	$161.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.62
Rate for Payer: Hamaspik Choice Inc Medicare	$230.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$299.81

GUIDEPIN SURG 3.2MM DIA 532

Facility

$461.25

Service Code	HCPCS C1769
Hospital Charge Code	64904480
Hospital Revenue Code	278
Min. Negotiated Rate	$230.62
Max. Negotiated Rate	$230.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.62
Rate for Payer: Hamaspik Choice Inc Medicare	$230.62

GUIDE PROBE 10G FORK SHP

Facility

$17.53

Hospital Charge Code	41301571
Hospital Revenue Code	270
Min. Negotiated Rate	$6.14
Max. Negotiated Rate	$14.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.76
Rate for Payer: Aetna Government	$8.76
Rate for Payer: Brighton Health Commercial	$13.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.92
Rate for Payer: Group Health Inc Commercial	$8.76
Rate for Payer: Group Health Inc Medicare	$6.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.76
Rate for Payer: Hamaspik Choice Inc Medicare	$8.76

GUIDEROD ORTHO KIRSCHNER 1

Facility

$125.00

Hospital Charge Code	64905967
Hospital Revenue Code	270
Min. Negotiated Rate	$43.75
Max. Negotiated Rate	$100.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.50
Rate for Payer: Aetna Government	$62.50
Rate for Payer: Brighton Health Commercial	$93.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.00
Rate for Payer: Group Health Inc Commercial	$62.50
Rate for Payer: Group Health Inc Medicare	$43.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.50
Rate for Payer: Hamaspik Choice Inc Medicare	$62.50

GUIDEROD ORTHOPEDIC POSITIONING

Facility

$580.00

Hospital Charge Code	64906038
Hospital Revenue Code	270
Min. Negotiated Rate	$203.00
Max. Negotiated Rate	$464.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$319.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$290.00
Rate for Payer: Aetna Government	$290.00
Rate for Payer: Brighton Health Commercial	$435.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$464.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$394.40
Rate for Payer: Group Health Inc Commercial	$290.00
Rate for Payer: Group Health Inc Medicare	$203.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.00
Rate for Payer: Hamaspik Choice Inc Medicare	$290.00

GUIDE VSP ORTHO

Facility

$4,125.00

Hospital Charge Code	64907398
Hospital Revenue Code	270
Min. Negotiated Rate	$1,443.75
Max. Negotiated Rate	$3,300.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,268.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,062.50
Rate for Payer: Aetna Government	$2,062.50
Rate for Payer: Brighton Health Commercial	$3,093.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,805.00
Rate for Payer: Group Health Inc Commercial	$2,062.50
Rate for Payer: Group Health Inc Medicare	$1,443.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,062.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,062.50

GUIDE WIRE

Facility

$342.00

Service Code	HCPCS C1769
Hospital Charge Code	40200516
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$171.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.00
Rate for Payer: Hamaspik Choice Inc Medicare	$171.00

GUIDE WIRE

Facility

$342.00

Service Code	HCPCS C1769
Hospital Charge Code	40200516
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$359.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$188.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$205.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$171.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$196.65
Rate for Payer: EmblemHealth Commercial	$171.00
Rate for Payer: Fidelis Medicare Advantage	$359.10
Rate for Payer: Group Health Inc Commercial	$171.00
Rate for Payer: Group Health Inc Medicare	$119.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.00
Rate for Payer: Hamaspik Choice Inc Medicare	$171.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$222.30

GUIDEWIRE

Facility

$312.50

Service Code	HCPCS C1769
Hospital Charge Code	40203081
Hospital Revenue Code	278
Min. Negotiated Rate	$156.25
Max. Negotiated Rate	$156.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$156.25
Rate for Payer: Hamaspik Choice Inc Medicare	$156.25

GUIDEWIRE

Facility

$223.75

Service Code	HCPCS C1769
Hospital Charge Code	64904582
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$234.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$134.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.66
Rate for Payer: EmblemHealth Commercial	$111.88
Rate for Payer: Fidelis Medicare Advantage	$234.94
Rate for Payer: Group Health Inc Commercial	$111.88
Rate for Payer: Group Health Inc Medicare	$78.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.88
Rate for Payer: Hamaspik Choice Inc Medicare	$111.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$145.44

Know your out-of-pocket cost for care.

All Charges