St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HETASTARCH-NACL 6-0.9 % IV SOLN [25174]

Facility

$0.06

Service Code	NDC 00264196510
Hospital Charge Code	00264196510
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03

HETASTARCH-NACL 6-0.9 % IV SOLN [25174]

Facility

$0.06

Service Code	NDC 00264196510
Hospital Charge Code	00264196510
Hospital Revenue Code	278
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.04
Rate for Payer: EmblemHealth Commercial	$0.03
Rate for Payer: Fidelis Medicare Advantage	$0.07
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.04

HEXAGONAL PHASE PHOSPHOLIPID

Facility

$44.95

Service Code	HCPCS 85598
Hospital Charge Code	40629220
Hospital Revenue Code	300
Rate for Payer: Cash Price	$17.98

HEXAGONAL PHASE PHOSPHOLIPID

Facility

$44.95

Service Code	HCPCS 85598
Hospital Charge Code	40629220
Hospital Revenue Code	300
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$33.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.98
Rate for Payer: Aetna Government	$17.98
Rate for Payer: Affinity Essential Plan 1&2	$12.59
Rate for Payer: Affinity Essential Plan 3&4	$12.59
Rate for Payer: Affinity Medicaid/CHP/HARP	$12.59
Rate for Payer: Brighton Health Commercial	$33.71
Rate for Payer: Cash Price	$17.98
Rate for Payer: Cash Price	$17.98
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$17.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.19
Rate for Payer: Elderplan Medicare Advantage	$17.98
Rate for Payer: EmblemHealth Commercial	$17.98
Rate for Payer: Fidelis Essential Plan Aliesa	$15.28
Rate for Payer: Fidelis Essential Plan QHP	$16.00
Rate for Payer: Fidelis Medicare Advantage	$17.98
Rate for Payer: Fidelis Qualified Health Plan	$16.00
Rate for Payer: Group Health Inc Commercial	$17.98
Rate for Payer: Group Health Inc Medicare	$17.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.48
Rate for Payer: Hamaspik Choice Inc Medicare	$17.98
Rate for Payer: Healthfirst Medicare Advantage	$17.98
Rate for Payer: Healthfirst QHP	$17.98
Rate for Payer: Humana Medicare	$18.34
Rate for Payer: Senior Whole Health Medicare Advantage	$17.98
Rate for Payer: United Healthcare Commercial	$22.77
Rate for Payer: United Healthcare Medicare Advantage	$17.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$14.38
Rate for Payer: Wellcare Medicare	$16.18

HEXAPOD STRUT ID KIT

Facility

$1,579.60

Service Code	HCPCS C1713
Hospital Charge Code	64907446
Hospital Revenue Code	278
Min. Negotiated Rate	$789.80
Max. Negotiated Rate	$789.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$789.80
Rate for Payer: Hamaspik Choice Inc Medicare	$789.80

HEXAPOD STRUT ID KIT

Facility

$1,579.60

Service Code	HCPCS C1713
Hospital Charge Code	64907446
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,658.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$868.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$947.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$789.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$908.27
Rate for Payer: EmblemHealth Commercial	$789.80
Rate for Payer: Fidelis Medicare Advantage	$1,658.58
Rate for Payer: Group Health Inc Commercial	$789.80
Rate for Payer: Group Health Inc Medicare	$552.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$789.80
Rate for Payer: Hamaspik Choice Inc Medicare	$789.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,026.74

HEX DRIVER WRENCH 2 MM

Facility

$320.00

Hospital Charge Code	40001781
Hospital Revenue Code	272
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$256.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$176.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$160.00
Rate for Payer: Aetna Government	$160.00
Rate for Payer: Brighton Health Commercial	$240.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$256.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$217.60
Rate for Payer: Group Health Inc Commercial	$160.00
Rate for Payer: Group Health Inc Medicare	$112.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$160.00

HEYMAN SYSTEM UROLOGISTS TRAY

Facility

$559.48

Hospital Charge Code	64905112
Hospital Revenue Code	270
Min. Negotiated Rate	$195.82
Max. Negotiated Rate	$447.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$307.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$279.74
Rate for Payer: Aetna Government	$279.74
Rate for Payer: Brighton Health Commercial	$419.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$447.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$380.45
Rate for Payer: Group Health Inc Commercial	$279.74
Rate for Payer: Group Health Inc Medicare	$195.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$279.74
Rate for Payer: Hamaspik Choice Inc Medicare	$279.74

HF1400 HEMOFILTER SET

Facility

$321.32

Hospital Charge Code	41640371
Hospital Revenue Code	270
Min. Negotiated Rate	$112.46
Max. Negotiated Rate	$257.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$176.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$160.66
Rate for Payer: Aetna Government	$160.66
Rate for Payer: Brighton Health Commercial	$240.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$257.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$218.50
Rate for Payer: Group Health Inc Commercial	$160.66
Rate for Payer: Group Health Inc Medicare	$112.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.66
Rate for Payer: Hamaspik Choice Inc Medicare	$160.66

HF1400 HEMOFILTER SET

Facility

$321.32

Hospital Charge Code	41650371
Hospital Revenue Code	270
Min. Negotiated Rate	$112.46
Max. Negotiated Rate	$257.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$176.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$160.66
Rate for Payer: Aetna Government	$160.66
Rate for Payer: Brighton Health Commercial	$240.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$257.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$218.50
Rate for Payer: Group Health Inc Commercial	$160.66
Rate for Payer: Group Health Inc Medicare	$112.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.66
Rate for Payer: Hamaspik Choice Inc Medicare	$160.66

HFN LAG SCREW 10.5MM X 100MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006105
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

HFN LAG SCREW 10.5MM X 100MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006105
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,017.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: EmblemHealth Commercial	$848.00
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

HFN LAG SCREW 10.5MM X 105MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006106
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

HFN LAG SCREW 10.5MM X 105MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006106
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,017.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: EmblemHealth Commercial	$848.00
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

HFN LAG SCREW 10.5MM X 110MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006107
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,017.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: EmblemHealth Commercial	$848.00
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

HFN LAG SCREW 10.5MM X 110MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006107
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

HFN LAG SCREW 10.5MM X 115MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006108
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

HFN LAG SCREW 10.5MM X 115MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006108
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,017.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: EmblemHealth Commercial	$848.00
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

HFN LAG SCREW 10.5MM X 120MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006109
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

HFN LAG SCREW 10.5MM X 120MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006109
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,017.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: EmblemHealth Commercial	$848.00
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

HFN LAG SCREW 10.5MM X 125MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006110
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

HFN LAG SCREW 10.5MM X 125MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006110
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,017.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: EmblemHealth Commercial	$848.00
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

HFN LAG SCREW 10.5MM X 130MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006111
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

HFN LAG SCREW 10.5MM X 130MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006111
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,017.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: EmblemHealth Commercial	$848.00
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

HFN LAG SCREW 10.5MM X 70MM

Facility

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40006099
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

Know your out-of-pocket cost for care.

All Charges