St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HOOD T4

Facility

$56.94

Hospital Charge Code	64905004
Hospital Revenue Code	270
Min. Negotiated Rate	$19.93
Max. Negotiated Rate	$45.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.47
Rate for Payer: Aetna Government	$28.47
Rate for Payer: Brighton Health Commercial	$42.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.72
Rate for Payer: Group Health Inc Commercial	$28.47
Rate for Payer: Group Health Inc Medicare	$19.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.47
Rate for Payer: Hamaspik Choice Inc Medicare	$28.47

HOOK EXTRACTION LARGE F/UNIVER

Facility

$1,518.75

Hospital Charge Code	64905995
Hospital Revenue Code	270
Min. Negotiated Rate	$531.56
Max. Negotiated Rate	$1,215.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$835.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$759.38
Rate for Payer: Aetna Government	$759.38
Rate for Payer: Brighton Health Commercial	$1,139.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,215.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,032.75
Rate for Payer: Group Health Inc Commercial	$759.38
Rate for Payer: Group Health Inc Medicare	$531.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$759.38
Rate for Payer: Hamaspik Choice Inc Medicare	$759.38

HOOK LAMINAR ANGLD BLD 5.0 SS

Facility

$1,310.00

Hospital Charge Code	40200827
Hospital Revenue Code	270
Min. Negotiated Rate	$458.50
Max. Negotiated Rate	$1,048.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$720.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$655.00
Rate for Payer: Aetna Government	$655.00
Rate for Payer: Brighton Health Commercial	$982.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,048.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$890.80
Rate for Payer: Group Health Inc Commercial	$655.00
Rate for Payer: Group Health Inc Medicare	$458.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$655.00
Rate for Payer: Hamaspik Choice Inc Medicare	$655.00

HOOK LAMINAR NARROW BLD 5.0 SS

Facility

$1,310.00

Hospital Charge Code	40200828
Hospital Revenue Code	270
Min. Negotiated Rate	$458.50
Max. Negotiated Rate	$1,048.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$720.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$655.00
Rate for Payer: Aetna Government	$655.00
Rate for Payer: Brighton Health Commercial	$982.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,048.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$890.80
Rate for Payer: Group Health Inc Commercial	$655.00
Rate for Payer: Group Health Inc Medicare	$458.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$655.00
Rate for Payer: Hamaspik Choice Inc Medicare	$655.00

HOOK LAMINAR REDUCE DIST 5.0

Facility

$1,310.00

Hospital Charge Code	40200829
Hospital Revenue Code	270
Min. Negotiated Rate	$458.50
Max. Negotiated Rate	$1,048.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$720.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$655.00
Rate for Payer: Aetna Government	$655.00
Rate for Payer: Brighton Health Commercial	$982.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,048.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$890.80
Rate for Payer: Group Health Inc Commercial	$655.00
Rate for Payer: Group Health Inc Medicare	$458.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$655.00
Rate for Payer: Hamaspik Choice Inc Medicare	$655.00

HOOK LAMINAR SS MOSS MIAMI 5.0

Facility

$2,050.00

Hospital Charge Code	40200831
Hospital Revenue Code	270
Min. Negotiated Rate	$717.50
Max. Negotiated Rate	$1,640.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,127.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,025.00
Rate for Payer: Aetna Government	$1,025.00
Rate for Payer: Brighton Health Commercial	$1,537.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,640.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,394.00
Rate for Payer: Group Health Inc Commercial	$1,025.00
Rate for Payer: Group Health Inc Medicare	$717.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,025.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,025.00

HOOK LAMINAR WIDE BLADE 5.0 SS

Facility

$1,240.00

Hospital Charge Code	40200832
Hospital Revenue Code	270
Min. Negotiated Rate	$434.00
Max. Negotiated Rate	$992.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$682.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$620.00
Rate for Payer: Aetna Government	$620.00
Rate for Payer: Brighton Health Commercial	$930.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$992.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$843.20
Rate for Payer: Group Health Inc Commercial	$620.00
Rate for Payer: Group Health Inc Medicare	$434.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$620.00
Rate for Payer: Hamaspik Choice Inc Medicare	$620.00

HOOK OFFSET WIDE

Facility

$2,050.00

Hospital Charge Code	40200833
Hospital Revenue Code	270
Min. Negotiated Rate	$717.50
Max. Negotiated Rate	$1,640.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,127.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,025.00
Rate for Payer: Aetna Government	$1,025.00
Rate for Payer: Brighton Health Commercial	$1,537.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,640.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,394.00
Rate for Payer: Group Health Inc Commercial	$1,025.00
Rate for Payer: Group Health Inc Medicare	$717.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,025.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,025.00

HOOK PEDICLE 5.0 SS MOSS MIAMI

Facility

$1,310.00

Hospital Charge Code	40200834
Hospital Revenue Code	270
Min. Negotiated Rate	$458.50
Max. Negotiated Rate	$1,048.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$720.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$655.00
Rate for Payer: Aetna Government	$655.00
Rate for Payer: Brighton Health Commercial	$982.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,048.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$890.80
Rate for Payer: Group Health Inc Commercial	$655.00
Rate for Payer: Group Health Inc Medicare	$458.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$655.00
Rate for Payer: Hamaspik Choice Inc Medicare	$655.00

HOOK PROBES SERFAS 3.5MM

Facility

$236.54

Hospital Charge Code	64906762
Hospital Revenue Code	270
Min. Negotiated Rate	$82.79
Max. Negotiated Rate	$189.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.27
Rate for Payer: Aetna Government	$118.27
Rate for Payer: Brighton Health Commercial	$177.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$189.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$160.85
Rate for Payer: Group Health Inc Commercial	$118.27
Rate for Payer: Group Health Inc Medicare	$82.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.27
Rate for Payer: Hamaspik Choice Inc Medicare	$118.27

HORIZON TITANIUM SUBTALAR 8MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	40209929
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,625.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,375.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
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

HORIZON TITANIUM SUBTALAR 8MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	40209929
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

HOSE, EXPANDABLE 75, 3 L

Facility

$18.60

Hospital Charge Code	64902066
Hospital Revenue Code	270
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$14.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.30
Rate for Payer: Aetna Government	$9.30
Rate for Payer: Brighton Health Commercial	$13.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.65
Rate for Payer: Group Health Inc Commercial	$9.30
Rate for Payer: Group Health Inc Medicare	$6.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.30
Rate for Payer: Hamaspik Choice Inc Medicare	$9.30

HOSE TOURNIQUET 13FTL DU

Facility

$167.85

Hospital Charge Code	64905095
Hospital Revenue Code	270
Min. Negotiated Rate	$58.75
Max. Negotiated Rate	$134.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$92.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$83.92
Rate for Payer: Aetna Government	$83.92
Rate for Payer: Brighton Health Commercial	$125.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$134.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$114.14
Rate for Payer: Group Health Inc Commercial	$83.92
Rate for Payer: Group Health Inc Medicare	$58.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$83.92
Rate for Payer: Hamaspik Choice Inc Medicare	$83.92

HOSPICE ANYTIME MSMT PER

Facility

$0.01

Service Code	HCPCS G9718
Hospital Charge Code	30307876
Hospital Revenue Code	510
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: United Healthcare Commercial	$222.00

HOSPICE ROOM AND BOARD

Facility

$4,093.10

Hospital Charge Code	30000116
Hospital Revenue Code	656
Min. Negotiated Rate	$1,432.58
Max. Negotiated Rate	$3,274.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,251.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,046.55
Rate for Payer: Aetna Government	$2,046.55
Rate for Payer: Brighton Health Commercial	$3,069.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,274.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,783.31
Rate for Payer: Group Health Inc Commercial	$2,046.55
Rate for Payer: Group Health Inc Medicare	$1,432.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,046.55
Rate for Payer: Hamaspik Choice Inc Medicare	$2,046.55

HOSPITAL OBSERVATION PER HOUR

Facility

$126.50

Service Code	HCPCS G0378
Hospital Charge Code	30000120
Hospital Revenue Code	762
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$2,500.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$835.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.68
Rate for Payer: Aetna Government	$1.68
Rate for Payer: Brighton Health Commercial	$1,927.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,983.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,685.77
Rate for Payer: Group Health Inc Commercial	$63.25
Rate for Payer: Group Health Inc Medicare	$44.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.25
Rate for Payer: Hamaspik Choice Inc Medicare	$63.25
Rate for Payer: Healthfirst Medicare Advantage	$2,500.00
Rate for Payer: United Healthcare Commercial	$2,278.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$350.00

HOSP OP CLINIC VISIT

Facility

$351.13

Service Code	HCPCS G0463
Hospital Charge Code	30305444
Hospital Revenue Code	510
Min. Negotiated Rate	$107.01
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$193.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$152.87
Rate for Payer: Aetna Government	$152.87
Rate for Payer: Affinity Essential Plan 1&2	$107.01
Rate for Payer: Affinity Essential Plan 3&4	$107.01
Rate for Payer: Affinity Medicaid/CHP/HARP	$107.01
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$152.87
Rate for Payer: Cash Price	$152.87
Rate for Payer: Cash Price	$152.87
Rate for Payer: Cash Price	$152.87
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$152.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Elderplan Medicare Advantage	$152.87
Rate for Payer: Fidelis Essential Plan Aliesa	$129.94
Rate for Payer: Fidelis Essential Plan QHP	$136.05
Rate for Payer: Fidelis Medicare Advantage	$152.87
Rate for Payer: Fidelis Qualified Health Plan	$136.05
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$175.56
Rate for Payer: Hamaspik Choice Inc Medicare	$152.87
Rate for Payer: Healthfirst Medicare Advantage	$129.94
Rate for Payer: Healthfirst QHP	$152.87
Rate for Payer: Humana Medicare	$155.93
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$152.87
Rate for Payer: Senior Whole Health Medicare Advantage	$152.87
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$152.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$152.87
Rate for Payer: Wellcare CHP/FHP/Medicaid	$122.30
Rate for Payer: Wellcare Medicare	$145.23

HOSP OP CLINIC VISIT

Facility

$351.13

Service Code	HCPCS G0463
Hospital Charge Code	30305444
Hospital Revenue Code	510
Rate for Payer: Cash Price	$152.87

HOSP RECD BY PT DUR MSMT PER

Facility

$0.01

Service Code	HCPCS G9723
Hospital Charge Code	30307900
Hospital Revenue Code	510
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: United Healthcare Commercial	$222.00

HOT PACK

Facility

$9.57

Hospital Charge Code	40204802
Hospital Revenue Code	270
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$7.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.78
Rate for Payer: Aetna Government	$4.78
Rate for Payer: Brighton Health Commercial	$7.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.51
Rate for Payer: Group Health Inc Commercial	$4.78
Rate for Payer: Group Health Inc Medicare	$3.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.78
Rate for Payer: Hamaspik Choice Inc Medicare	$4.78

HOWMAN RETRACTOR

Facility

$625.00

Hospital Charge Code	64905079
Hospital Revenue Code	270
Min. Negotiated Rate	$218.75
Max. Negotiated Rate	$500.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$312.50
Rate for Payer: Aetna Government	$312.50
Rate for Payer: Brighton Health Commercial	$468.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$425.00
Rate for Payer: Group Health Inc Commercial	$312.50
Rate for Payer: Group Health Inc Medicare	$218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50

HOWMEDICA BI-POLAR PROSTHESIS

Facility

$7,908.23

Hospital Charge Code	40207028
Hospital Revenue Code	270
Min. Negotiated Rate	$2,767.88
Max. Negotiated Rate	$6,326.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,349.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,954.12
Rate for Payer: Aetna Government	$3,954.12
Rate for Payer: Brighton Health Commercial	$5,931.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,326.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,377.60
Rate for Payer: Group Health Inc Commercial	$3,954.12
Rate for Payer: Group Health Inc Medicare	$2,767.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,954.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3,954.12

HOWMEDICA FEMORAL COMP CEMENTED

Facility

$6,879.60

Service Code	HCPCS C1776
Hospital Charge Code	40024054
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,223.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,783.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,127.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,439.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,955.77
Rate for Payer: EmblemHealth Commercial	$3,439.80
Rate for Payer: Fidelis Medicare Advantage	$7,223.58
Rate for Payer: Group Health Inc Commercial	$3,439.80
Rate for Payer: Group Health Inc Medicare	$2,407.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,439.80
Rate for Payer: Hamaspik Choice Inc Medicare	$3,439.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,471.74

HOWMEDICA FEMORAL COMP CEMENTED

Facility

$6,879.60

Service Code	HCPCS C1776
Hospital Charge Code	40024054
Hospital Revenue Code	278
Min. Negotiated Rate	$3,439.80
Max. Negotiated Rate	$3,439.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,439.80
Rate for Payer: Hamaspik Choice Inc Medicare	$3,439.80

Know your out-of-pocket cost for care.

All Charges