St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ANCHOR LUNBAR SA 10X22X30MMX12

Facility

$23,220.00

Service Code	HCPCS C1713
Hospital Charge Code	64905080
Hospital Revenue Code	278
Min. Negotiated Rate	$11,610.00
Max. Negotiated Rate	$11,610.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,610.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,610.00

ANCHOR LUNBAR SA 10X22X30MMX12

Facility

$23,220.00

Service Code	HCPCS C1713
Hospital Charge Code	64905080
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$24,381.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12,771.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$13,932.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11,610.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13,351.50
Rate for Payer: EmblemHealth Commercial	$11,610.00
Rate for Payer: Fidelis Medicare Advantage	$24,381.00
Rate for Payer: Group Health Inc Commercial	$11,610.00
Rate for Payer: Group Health Inc Medicare	$8,127.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,610.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,610.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15,093.00

ANCHOR MENISCAL REPAIR 0-DEG

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	64902440
Hospital Revenue Code	278
Min. Negotiated Rate	$455.00
Max. Negotiated Rate	$455.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$455.00
Rate for Payer: Hamaspik Choice Inc Medicare	$455.00

ANCHOR MENISCAL REPAIR 0-DEG

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	64902440
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$955.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$500.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$546.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$455.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$523.25
Rate for Payer: EmblemHealth Commercial	$455.00
Rate for Payer: Fidelis Medicare Advantage	$955.50
Rate for Payer: Group Health Inc Commercial	$455.00
Rate for Payer: Group Health Inc Medicare	$318.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$455.00
Rate for Payer: Hamaspik Choice Inc Medicare	$455.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$591.50

ANCHOR MENISCAL REPAIR 12-DEG

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	64902436
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$955.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$500.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$546.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$455.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$523.25
Rate for Payer: EmblemHealth Commercial	$455.00
Rate for Payer: Fidelis Medicare Advantage	$955.50
Rate for Payer: Group Health Inc Commercial	$455.00
Rate for Payer: Group Health Inc Medicare	$318.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$455.00
Rate for Payer: Hamaspik Choice Inc Medicare	$455.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$591.50

ANCHOR MENISCAL REPAIR 12-DEG

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	64902436
Hospital Revenue Code	278
Min. Negotiated Rate	$455.00
Max. Negotiated Rate	$455.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$455.00
Rate for Payer: Hamaspik Choice Inc Medicare	$455.00

ANCHOR MENISCAL REPAIR 27-DEG

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64902438
Hospital Revenue Code	278
Min. Negotiated Rate	$437.50
Max. Negotiated Rate	$437.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50

ANCHOR MENISCAL REPAIR 27-DEG

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64902438
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$918.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$481.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$525.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$437.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$503.12
Rate for Payer: EmblemHealth Commercial	$437.50
Rate for Payer: Fidelis Medicare Advantage	$918.75
Rate for Payer: Group Health Inc Commercial	$437.50
Rate for Payer: Group Health Inc Medicare	$306.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$568.75

ANCHOR MINI QUICK PLUS W/2/0 CORD

Facility

$1,210.00

Service Code	HCPCS C1713
Hospital Charge Code	64902319
Hospital Revenue Code	278
Min. Negotiated Rate	$605.00
Max. Negotiated Rate	$605.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$605.00
Rate for Payer: Hamaspik Choice Inc Medicare	$605.00

ANCHOR MINI QUICK PLUS W/2/0 CORD

Facility

$1,210.00

Service Code	HCPCS C1713
Hospital Charge Code	64902319
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,270.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$665.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$726.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$605.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$695.75
Rate for Payer: EmblemHealth Commercial	$605.00
Rate for Payer: Fidelis Medicare Advantage	$1,270.50
Rate for Payer: Group Health Inc Commercial	$605.00
Rate for Payer: Group Health Inc Medicare	$423.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$605.00
Rate for Payer: Hamaspik Choice Inc Medicare	$605.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$786.50

ANCHOR, Q11 QA PLUS, O/C

Facility

$1,212.50

Service Code	HCPCS C1713
Hospital Charge Code	64905609
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,273.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$666.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$727.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$606.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$697.19
Rate for Payer: EmblemHealth Commercial	$606.25
Rate for Payer: Fidelis Medicare Advantage	$1,273.12
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$788.12

ANCHOR, Q11 QA PLUS, O/C

Facility

$1,212.50

Service Code	HCPCS C1713
Hospital Charge Code	64905609
Hospital Revenue Code	278
Min. Negotiated Rate	$606.25
Max. Negotiated Rate	$606.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$606.25
Rate for Payer: Hamaspik Choice Inc Medicare	$606.25

ANCHOR QUICK GII W/2 ETHIBOND

Facility

$1,212.50

Service Code	HCPCS C1713
Hospital Charge Code	64901606
Hospital Revenue Code	278
Min. Negotiated Rate	$606.25
Max. Negotiated Rate	$606.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$606.25
Rate for Payer: Hamaspik Choice Inc Medicare	$606.25

ANCHOR QUICK GII W/2 ETHIBOND

Facility

$1,212.50

Service Code	HCPCS C1713
Hospital Charge Code	64901606
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,273.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$666.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$727.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$606.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$697.19
Rate for Payer: EmblemHealth Commercial	$606.25
Rate for Payer: Fidelis Medicare Advantage	$1,273.12
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$788.12

ANCHOR, SUPER QA PLUS, DS O/C

Facility

$1,212.50

Service Code	HCPCS C1713
Hospital Charge Code	64905608
Hospital Revenue Code	278
Min. Negotiated Rate	$606.25
Max. Negotiated Rate	$606.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$606.25
Rate for Payer: Hamaspik Choice Inc Medicare	$606.25

ANCHOR, SUPER QA PLUS, DS O/C

Facility

$1,212.50

Service Code	HCPCS C1713
Hospital Charge Code	64905608
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,273.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$666.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$727.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$606.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$697.19
Rate for Payer: EmblemHealth Commercial	$606.25
Rate for Payer: Fidelis Medicare Advantage	$1,273.12
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$788.12

Anderson Tube

Facility

$90.02

Hospital Charge Code	40200338
Hospital Revenue Code	270
Min. Negotiated Rate	$31.51
Max. Negotiated Rate	$72.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.01
Rate for Payer: Aetna Government	$45.01
Rate for Payer: Brighton Health Commercial	$67.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.21
Rate for Payer: Group Health Inc Commercial	$45.01
Rate for Payer: Group Health Inc Medicare	$31.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.01
Rate for Payer: Hamaspik Choice Inc Medicare	$45.01

ANESTHESIA EXT. SET

Facility

$2.48

Hospital Charge Code	40509815
Hospital Revenue Code	260
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$76.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.24
Rate for Payer: Aetna Government	$1.24
Rate for Payer: Brighton Health Commercial	$1.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.69
Rate for Payer: Group Health Inc Commercial	$1.24
Rate for Payer: Group Health Inc Medicare	$0.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.24
Rate for Payer: Hamaspik Choice Inc Medicare	$1.24
Rate for Payer: United Healthcare Commercial	$76.00

ANESTHESIA TIME 1ST HOUR

Facility

$1,215.00

Hospital Charge Code	40004410
Hospital Revenue Code	370
Min. Negotiated Rate	$425.25
Max. Negotiated Rate	$972.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$668.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$607.50
Rate for Payer: Aetna Government	$607.50
Rate for Payer: Brighton Health Commercial	$911.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$972.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$826.20
Rate for Payer: Group Health Inc Commercial	$607.50
Rate for Payer: Group Health Inc Medicare	$425.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$607.50
Rate for Payer: Hamaspik Choice Inc Medicare	$607.50

ANESTHESIA TIME ADD'L 15 MINS

Facility

$121.50

Hospital Charge Code	64900711
Hospital Revenue Code	370
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$97.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.75
Rate for Payer: Aetna Government	$60.75
Rate for Payer: Brighton Health Commercial	$91.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.62
Rate for Payer: Group Health Inc Commercial	$60.75
Rate for Payer: Group Health Inc Medicare	$42.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.75
Rate for Payer: Hamaspik Choice Inc Medicare	$60.75

ANESTHESIA TIME EA ADDL 15 MIN

Facility

$121.50

Hospital Charge Code	40004411
Hospital Revenue Code	370
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$97.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.75
Rate for Payer: Aetna Government	$60.75
Rate for Payer: Brighton Health Commercial	$91.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.62
Rate for Payer: Group Health Inc Commercial	$60.75
Rate for Payer: Group Health Inc Medicare	$42.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.75
Rate for Payer: Hamaspik Choice Inc Medicare	$60.75

ANESTHESIA TIME FIRST HOUR

Facility

$1,215.00

Hospital Charge Code	64900710
Hospital Revenue Code	370
Min. Negotiated Rate	$425.25
Max. Negotiated Rate	$972.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$668.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$607.50
Rate for Payer: Aetna Government	$607.50
Rate for Payer: Brighton Health Commercial	$911.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$972.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$826.20
Rate for Payer: Group Health Inc Commercial	$607.50
Rate for Payer: Group Health Inc Medicare	$425.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$607.50
Rate for Payer: Hamaspik Choice Inc Medicare	$607.50

ANGEL BLOOD ACCESS KT

Facility

$270.00

Hospital Charge Code	64905940
Hospital Revenue Code	270
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$216.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$135.00
Rate for Payer: Aetna Government	$135.00
Rate for Payer: Brighton Health Commercial	$202.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$216.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.60
Rate for Payer: Group Health Inc Commercial	$135.00
Rate for Payer: Group Health Inc Medicare	$94.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.00
Rate for Payer: Hamaspik Choice Inc Medicare	$135.00

ANGELMAN/PWS METHYLATION ASSAY

Facility

$127.68

Service Code	HCPCS 81331
Hospital Charge Code	40609029
Hospital Revenue Code	310
Rate for Payer: Cash Price	$51.07

ANGELMAN/PWS METHYLATION ASSAY

Facility

$127.68

Service Code	HCPCS 81331
Hospital Charge Code	40609029
Hospital Revenue Code	310
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$102.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.07
Rate for Payer: Aetna Government	$51.07
Rate for Payer: Affinity Essential Plan 1&2	$35.75
Rate for Payer: Affinity Essential Plan 3&4	$35.75
Rate for Payer: Affinity Medicaid/CHP/HARP	$35.75
Rate for Payer: Brighton Health Commercial	$51.07
Rate for Payer: Cash Price	$51.07
Rate for Payer: Cash Price	$51.07
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$51.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$102.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.82
Rate for Payer: Elderplan Medicare Advantage	$51.07
Rate for Payer: EmblemHealth Commercial	$51.07
Rate for Payer: Fidelis Essential Plan Aliesa	$43.41
Rate for Payer: Fidelis Essential Plan QHP	$45.45
Rate for Payer: Fidelis Medicare Advantage	$51.07
Rate for Payer: Fidelis Qualified Health Plan	$45.45
Rate for Payer: Group Health Inc Commercial	$51.07
Rate for Payer: Group Health Inc Medicare	$51.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.84
Rate for Payer: Hamaspik Choice Inc Medicare	$51.07
Rate for Payer: Healthfirst Medicare Advantage	$51.07
Rate for Payer: Healthfirst QHP	$51.07
Rate for Payer: Humana Medicare	$52.09
Rate for Payer: Senior Whole Health Medicare Advantage	$51.07
Rate for Payer: United Healthcare Medicare Advantage	$51.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$51.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$40.86
Rate for Payer: Wellcare Medicare	$45.96

Know your out-of-pocket cost for care.

All Charges