St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ CARDIVA BOOMERANG CLOSURE WIRE

Facility OP

$3,000.00

Hospital Charge Code	41569913
Hospital Revenue Code	270
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,500.00
Rate for Payer: Aetna Government	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,040.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

ZZ CASSI II BIOPSY DEVI/SYS

Facility OP

$490.00

Hospital Charge Code	41569957
Hospital Revenue Code	279
Min. Negotiated Rate	$171.50
Max. Negotiated Rate	$392.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$269.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$245.00
Rate for Payer: Aetna Government	$245.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$392.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$333.20
Rate for Payer: Group Health Inc Commercial	$245.00
Rate for Payer: Group Health Inc Medicare	$171.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00

ZZ CAT8 TORQ 85CM 8F

Facility OP

$5,980.00

Hospital Charge Code	41563142
Hospital Revenue Code	272
Min. Negotiated Rate	$2,093.00
Max. Negotiated Rate	$4,784.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,289.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,990.00
Rate for Payer: Aetna Government	$2,990.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,784.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,066.40
Rate for Payer: Group Health Inc Commercial	$2,990.00
Rate for Payer: Group Health Inc Medicare	$2,093.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,990.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,990.00

ZZ CATH 1H 4 FR 035-100

Facility OP

$46.78

Service Code	HCPCS C1725
Hospital Charge Code	41569697
Hospital Revenue Code	278
Min. Negotiated Rate	$16.37
Max. Negotiated Rate	$49.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.73
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	$23.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.90
Rate for Payer: Fidelis Medicare Advantage	$49.12
Rate for Payer: Group Health Inc Commercial	$23.39
Rate for Payer: Group Health Inc Medicare	$16.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.39
Rate for Payer: Hamaspik Choice Inc Medicare	$23.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$30.41

ZZ CATH 1H 4 FR 035-100

Facility IP

$46.78

Service Code	HCPCS C1725
Hospital Charge Code	41569697
Hospital Revenue Code	278
Min. Negotiated Rate	$23.39
Max. Negotiated Rate	$23.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.39
Rate for Payer: Hamaspik Choice Inc Medicare	$23.39

ZZ CATH/65/CI/SUPPER TORQUE

Facility IP

$32.96

Service Code	HCPCS C1725
Hospital Charge Code	41569377
Hospital Revenue Code	278
Min. Negotiated Rate	$16.48
Max. Negotiated Rate	$16.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.48
Rate for Payer: Hamaspik Choice Inc Medicare	$16.48

ZZ CATH/65/CI/SUPPER TORQUE

Facility OP

$32.96

Service Code	HCPCS C1725
Hospital Charge Code	41569377
Hospital Revenue Code	278
Min. Negotiated Rate	$11.54
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.13
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	$16.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.95
Rate for Payer: Fidelis Medicare Advantage	$34.61
Rate for Payer: Group Health Inc Commercial	$16.48
Rate for Payer: Group Health Inc Medicare	$11.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.48
Rate for Payer: Hamaspik Choice Inc Medicare	$16.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.42

ZZ CATH/6F/PIG/90CM/1200PSI

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569379
Hospital Revenue Code	278
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
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	$16.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.58
Rate for Payer: Fidelis Medicare Advantage	$33.94
Rate for Payer: Group Health Inc Commercial	$16.16
Rate for Payer: Group Health Inc Medicare	$11.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.01

ZZ CATH/6F/PIG/90CM/1200PSI

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569379
Hospital Revenue Code	278
Min. Negotiated Rate	$16.16
Max. Negotiated Rate	$16.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16

ZZ CATH/COBRA1/4F/.035/65CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569380
Hospital Revenue Code	278
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
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	$16.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.58
Rate for Payer: Fidelis Medicare Advantage	$33.94
Rate for Payer: Group Health Inc Commercial	$16.16
Rate for Payer: Group Health Inc Medicare	$11.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.01

ZZ CATH/COBRA1/4F/.035/65CM

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569380
Hospital Revenue Code	278
Min. Negotiated Rate	$16.16
Max. Negotiated Rate	$16.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16

ZZ CATH/COBRA1/5F/.035/100CM

Facility IP

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569381
Hospital Revenue Code	278
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.60
Rate for Payer: Hamaspik Choice Inc Medicare	$18.60

ZZ CATH/COBRA1/5F/.035/100CM

Facility OP

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569381
Hospital Revenue Code	278
Min. Negotiated Rate	$13.02
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.47
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	$18.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.40
Rate for Payer: Fidelis Medicare Advantage	$39.07
Rate for Payer: Group Health Inc Commercial	$18.60
Rate for Payer: Group Health Inc Medicare	$13.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.60
Rate for Payer: Hamaspik Choice Inc Medicare	$18.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$24.19

ZZ CATH/COBRA1/5F/.035/65CM

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569382
Hospital Revenue Code	278
Min. Negotiated Rate	$16.16
Max. Negotiated Rate	$16.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16

ZZ CATH/COBRA1/5F/.035/65CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569382
Hospital Revenue Code	278
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
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	$16.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.58
Rate for Payer: Fidelis Medicare Advantage	$33.94
Rate for Payer: Group Health Inc Commercial	$16.16
Rate for Payer: Group Health Inc Medicare	$11.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.01

ZZ CATH COBRA 1 5FR 035-90CM

Facility IP

$56.00

Service Code	HCPCS C1725
Hospital Charge Code	41569730
Hospital Revenue Code	278
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.00
Rate for Payer: Hamaspik Choice Inc Medicare	$28.00

ZZ CATH COBRA 1 5FR 035-90CM

Facility OP

$56.00

Service Code	HCPCS C1725
Hospital Charge Code	41569730
Hospital Revenue Code	278
Min. Negotiated Rate	$19.60
Max. Negotiated Rate	$58.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.80
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	$28.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.20
Rate for Payer: Fidelis Medicare Advantage	$58.80
Rate for Payer: Group Health Inc Commercial	$28.00
Rate for Payer: Group Health Inc Medicare	$19.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.00
Rate for Payer: Hamaspik Choice Inc Medicare	$28.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.40

ZZ CATH COBRA 1 PEDS 5FR 035-65CM

Facility IP

$24.10

Service Code	HCPCS C1725
Hospital Charge Code	41569731
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$12.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.05
Rate for Payer: Hamaspik Choice Inc Medicare	$12.05

ZZ CATH COBRA 1 PEDS 5FR 035-65CM

Facility OP

$24.10

Service Code	HCPCS C1725
Hospital Charge Code	41569731
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.26
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	$12.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.86
Rate for Payer: Fidelis Medicare Advantage	$25.30
Rate for Payer: Group Health Inc Commercial	$12.05
Rate for Payer: Group Health Inc Medicare	$8.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.05
Rate for Payer: Hamaspik Choice Inc Medicare	$12.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.66

ZZ CATH COBRA1 SELECT 5FR 035-65

Facility OP

$50.89

Service Code	HCPCS C1725
Hospital Charge Code	41569707
Hospital Revenue Code	278
Min. Negotiated Rate	$17.81
Max. Negotiated Rate	$53.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.99
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	$25.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.26
Rate for Payer: Fidelis Medicare Advantage	$53.43
Rate for Payer: Group Health Inc Commercial	$25.44
Rate for Payer: Group Health Inc Medicare	$17.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.44
Rate for Payer: Hamaspik Choice Inc Medicare	$25.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.08

ZZ CATH COBRA1 SELECT 5FR 035-65

Facility IP

$50.89

Service Code	HCPCS C1725
Hospital Charge Code	41569707
Hospital Revenue Code	278
Min. Negotiated Rate	$25.44
Max. Negotiated Rate	$25.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.44
Rate for Payer: Hamaspik Choice Inc Medicare	$25.44

ZZ CATH/COBRA2/4F/.035/65CM

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569383
Hospital Revenue Code	278
Min. Negotiated Rate	$16.16
Max. Negotiated Rate	$16.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16

ZZ CATH/COBRA2/4F/.035/65CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569383
Hospital Revenue Code	278
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
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	$16.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.58
Rate for Payer: Fidelis Medicare Advantage	$33.94
Rate for Payer: Group Health Inc Commercial	$16.16
Rate for Payer: Group Health Inc Medicare	$11.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.01

ZZ CATH/COBRA2/5F/.035

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569384
Hospital Revenue Code	278
Min. Negotiated Rate	$16.16
Max. Negotiated Rate	$16.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16

ZZ CATH/COBRA2/5F/.035

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569384
Hospital Revenue Code	278
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
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	$16.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.58
Rate for Payer: Fidelis Medicare Advantage	$33.94
Rate for Payer: Group Health Inc Commercial	$16.16
Rate for Payer: Group Health Inc Medicare	$11.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.01

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