St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ AMPLATZ SP STIF 35-260

Facility OP

$136.79

Service Code	HCPCS C1769
Hospital Charge Code	41567124
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$143.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$75.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$68.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.65
Rate for Payer: Fidelis Medicare Advantage	$143.63
Rate for Payer: Group Health Inc Commercial	$68.40
Rate for Payer: Group Health Inc Medicare	$47.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.40
Rate for Payer: Hamaspik Choice Inc Medicare	$68.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$88.91

ZZ AMPLATZ SP STIF 35-260

Facility IP

$136.79

Service Code	HCPCS C1769
Hospital Charge Code	41567124
Hospital Revenue Code	278
Min. Negotiated Rate	$68.40
Max. Negotiated Rate	$68.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.40
Rate for Payer: Hamaspik Choice Inc Medicare	$68.40

ZZ AMPLATZ SP STIF 35-75

Facility OP

$84.69

Service Code	HCPCS C1769
Hospital Charge Code	41567126
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$88.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.70
Rate for Payer: Fidelis Medicare Advantage	$88.92
Rate for Payer: Group Health Inc Commercial	$42.34
Rate for Payer: Group Health Inc Medicare	$29.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.34
Rate for Payer: Hamaspik Choice Inc Medicare	$42.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$55.05

ZZ AMPLATZ SP STIF 35-75

Facility IP

$84.69

Service Code	HCPCS C1769
Hospital Charge Code	41567126
Hospital Revenue Code	278
Min. Negotiated Rate	$42.34
Max. Negotiated Rate	$42.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.34
Rate for Payer: Hamaspik Choice Inc Medicare	$42.34

ZZ AMPLATZ SP STIF 35/755

Facility IP

$81.51

Service Code	HCPCS C1769
Hospital Charge Code	41567125
Hospital Revenue Code	278
Min. Negotiated Rate	$40.76
Max. Negotiated Rate	$40.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.76
Rate for Payer: Hamaspik Choice Inc Medicare	$40.76

ZZ AMPLATZ SP STIF 35/755

Facility OP

$81.51

Service Code	HCPCS C1769
Hospital Charge Code	41567125
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$85.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.87
Rate for Payer: Fidelis Medicare Advantage	$85.59
Rate for Payer: Group Health Inc Commercial	$40.76
Rate for Payer: Group Health Inc Medicare	$28.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.76
Rate for Payer: Hamaspik Choice Inc Medicare	$40.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.98

ZZ AMPLT SS GDW 032/145

Facility OP

$70.88

Service Code	HCPCS C1769
Hospital Charge Code	41569776
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$74.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.76
Rate for Payer: Fidelis Medicare Advantage	$74.42
Rate for Payer: Group Health Inc Commercial	$35.44
Rate for Payer: Group Health Inc Medicare	$24.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.44
Rate for Payer: Hamaspik Choice Inc Medicare	$35.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.07

ZZ AMPLT SS GDW 032/145

Facility IP

$70.88

Service Code	HCPCS C1769
Hospital Charge Code	41569776
Hospital Revenue Code	278
Min. Negotiated Rate	$35.44
Max. Negotiated Rate	$35.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.44
Rate for Payer: Hamaspik Choice Inc Medicare	$35.44

ZZ ANGIODYN 5F OMNFLUSH

Facility OP

$45.08

Service Code	HCPCS C1725
Hospital Charge Code	41569600
Hospital Revenue Code	278
Min. Negotiated Rate	$15.78
Max. Negotiated Rate	$47.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.92
Rate for Payer: Fidelis Medicare Advantage	$47.33
Rate for Payer: Group Health Inc Commercial	$22.54
Rate for Payer: Group Health Inc Medicare	$15.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.54
Rate for Payer: Hamaspik Choice Inc Medicare	$22.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$29.30

ZZ ANGIODYN 5F OMNFLUSH

Facility IP

$45.08

Service Code	HCPCS C1725
Hospital Charge Code	41569600
Hospital Revenue Code	278
Min. Negotiated Rate	$22.54
Max. Negotiated Rate	$22.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.54
Rate for Payer: Hamaspik Choice Inc Medicare	$22.54

ZZ ANGIODYN 5F STRFLUSH

Facility IP

$35.44

Service Code	HCPCS C1725
Hospital Charge Code	41569601
Hospital Revenue Code	278
Min. Negotiated Rate	$17.72
Max. Negotiated Rate	$17.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.72
Rate for Payer: Hamaspik Choice Inc Medicare	$17.72

ZZ ANGIODYN 5F STRFLUSH

Facility OP

$35.44

Service Code	HCPCS C1725
Hospital Charge Code	41569601
Hospital Revenue Code	278
Min. Negotiated Rate	$12.40
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.38
Rate for Payer: Fidelis Medicare Advantage	$37.21
Rate for Payer: Group Health Inc Commercial	$17.72
Rate for Payer: Group Health Inc Medicare	$12.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.72
Rate for Payer: Hamaspik Choice Inc Medicare	$17.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23.04

ZZ ANGIOGRAPHY KIT

Facility OP

$89.66

Hospital Charge Code	41567000
Hospital Revenue Code	270
Min. Negotiated Rate	$31.38
Max. Negotiated Rate	$71.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.83
Rate for Payer: Aetna Government	$44.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.97
Rate for Payer: Group Health Inc Commercial	$44.83
Rate for Payer: Group Health Inc Medicare	$31.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.83
Rate for Payer: Hamaspik Choice Inc Medicare	$44.83

ZZ ANGIO-SEAL 6F

Facility OP

$580.00

Service Code	HCPCS C1760
Hospital Charge Code	41561951
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$609.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$319.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.50
Rate for Payer: Aetna Government	$73.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$290.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$333.50
Rate for Payer: Fidelis Medicare Advantage	$609.00
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$377.00

ZZ ANGIO-SEAL 6F

Facility IP

$580.00

Service Code	HCPCS C1760
Hospital Charge Code	41561951
Hospital Revenue Code	278
Min. Negotiated Rate	$290.00
Max. Negotiated Rate	$290.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.00
Rate for Payer: Hamaspik Choice Inc Medicare	$290.00

ZZ ANGIOTECH NEEDLE GUIDE

Facility OP

$26.00

Hospital Charge Code	41564610
Hospital Revenue Code	272
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$20.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.00
Rate for Payer: Aetna Government	$13.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.68
Rate for Payer: Group Health Inc Commercial	$13.00
Rate for Payer: Group Health Inc Medicare	$9.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.00
Rate for Payer: Hamaspik Choice Inc Medicare	$13.00

ZZ ANGULAR BOLSTER ENDURA

Facility OP

$344.81

Hospital Charge Code	41567311
Hospital Revenue Code	270
Min. Negotiated Rate	$120.68
Max. Negotiated Rate	$275.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$189.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$172.40
Rate for Payer: Aetna Government	$172.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$275.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$234.47
Rate for Payer: Group Health Inc Commercial	$172.40
Rate for Payer: Group Health Inc Medicare	$120.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.40
Rate for Payer: Hamaspik Choice Inc Medicare	$172.40

ZZ AP DRNG 10F

Facility OP

$212.77

Hospital Charge Code	41569639
Hospital Revenue Code	270
Min. Negotiated Rate	$74.47
Max. Negotiated Rate	$170.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$117.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$106.38
Rate for Payer: Aetna Government	$106.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.68
Rate for Payer: Group Health Inc Commercial	$106.38
Rate for Payer: Group Health Inc Medicare	$74.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.38
Rate for Payer: Hamaspik Choice Inc Medicare	$106.38

ZZ ARGON CLEANER 6F X 65CM

Facility OP

$500.00

Hospital Charge Code	41563507
Hospital Revenue Code	272
Min. Negotiated Rate	$175.00
Max. Negotiated Rate	$400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$250.00
Rate for Payer: Aetna Government	$250.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$340.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

ZZ ARGON CO-AX INTRO NEEDLE

Facility OP

$15.52

Hospital Charge Code	41540610
Hospital Revenue Code	272
Min. Negotiated Rate	$5.43
Max. Negotiated Rate	$12.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.76
Rate for Payer: Aetna Government	$7.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.55
Rate for Payer: Group Health Inc Commercial	$7.76
Rate for Payer: Group Health Inc Medicare	$5.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.76
Rate for Payer: Hamaspik Choice Inc Medicare	$7.76

ZZ ARGON FULL CORE BX INSTRUMENT

Facility OP

$47.00

Hospital Charge Code	41540609
Hospital Revenue Code	272
Min. Negotiated Rate	$16.45
Max. Negotiated Rate	$37.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.50
Rate for Payer: Aetna Government	$23.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.96
Rate for Payer: Group Health Inc Commercial	$23.50
Rate for Payer: Group Health Inc Medicare	$16.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.50
Rate for Payer: Hamaspik Choice Inc Medicare	$23.50

ZZ ARGON SUPERCORE BX INSTRUMENT

Facility OP

$80.00

Hospital Charge Code	41563212
Hospital Revenue Code	272
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$64.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$40.00
Rate for Payer: Aetna Government	$40.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$64.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$54.40
Rate for Payer: Group Health Inc Commercial	$40.00
Rate for Payer: Group Health Inc Medicare	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00

ZZ ARGON VENA CAVA FILTER

Facility OP

$2,400.00

Service Code	HCPCS C1880
Hospital Charge Code	66520352
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$2,520.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,380.00
Rate for Payer: Fidelis Medicare Advantage	$2,520.00
Rate for Payer: Group Health Inc Commercial	$1,200.00
Rate for Payer: Group Health Inc Medicare	$840.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,560.00

ZZ ARGON VENA CAVA FILTER

Facility IP

$2,400.00

Service Code	HCPCS C1880
Hospital Charge Code	66520352
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.00

ZZ ARROW-TREROTOLA PTD KIT

Facility OP

$1,200.00

Hospital Charge Code	41568615
Hospital Revenue Code	279
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$960.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$660.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$600.00
Rate for Payer: Aetna Government	$600.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$960.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$816.00
Rate for Payer: Group Health Inc Commercial	$600.00
Rate for Payer: Group Health Inc Medicare	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00

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