St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ CATHGLIDE COBRA I 4FR038 65CM

Facility OP

$9.11

Service Code	HCPCS C1725
Hospital Charge Code	41569665
Hospital Revenue Code	278
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.01
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	$4.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.24
Rate for Payer: Fidelis Medicare Advantage	$9.57
Rate for Payer: Group Health Inc Commercial	$4.56
Rate for Payer: Group Health Inc Medicare	$3.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.56
Rate for Payer: Hamaspik Choice Inc Medicare	$4.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.92

ZZ CATHGLIDE COBRA I 5FR 65CM

Facility OP

$9.11

Hospital Charge Code	41569666
Hospital Revenue Code	270
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$7.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.56
Rate for Payer: Aetna Government	$4.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.19
Rate for Payer: Group Health Inc Commercial	$4.56
Rate for Payer: Group Health Inc Medicare	$3.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.56
Rate for Payer: Hamaspik Choice Inc Medicare	$4.56

ZZ CATH/GRALLMAN/7F/100CM

Facility IP

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569393
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/GRALLMAN/7F/100CM

Facility OP

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569393
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/GUIDING/5CV/6F/55CM

Facility OP

$233.89

Service Code	HCPCS C1725
Hospital Charge Code	41569395
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$245.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$128.64
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	$116.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.49
Rate for Payer: Fidelis Medicare Advantage	$245.58
Rate for Payer: Group Health Inc Commercial	$116.94
Rate for Payer: Group Health Inc Medicare	$81.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$116.94
Rate for Payer: Hamaspik Choice Inc Medicare	$116.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$152.03

ZZ CATH/GUIDING/5CV/6F/55CM

Facility IP

$233.89

Service Code	HCPCS C1725
Hospital Charge Code	41569395
Hospital Revenue Code	278
Min. Negotiated Rate	$116.94
Max. Negotiated Rate	$116.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$116.94
Rate for Payer: Hamaspik Choice Inc Medicare	$116.94

ZZ CATH/GUIDING/6F/MPA1/90CM

Facility IP

$233.89

Service Code	HCPCS C1725
Hospital Charge Code	41569394
Hospital Revenue Code	278
Min. Negotiated Rate	$116.94
Max. Negotiated Rate	$116.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$116.94
Rate for Payer: Hamaspik Choice Inc Medicare	$116.94

ZZ CATH/GUIDING/6F/MPA1/90CM

Facility OP

$233.89

Service Code	HCPCS C1725
Hospital Charge Code	41569394
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$245.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$128.64
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	$116.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.49
Rate for Payer: Fidelis Medicare Advantage	$245.58
Rate for Payer: Group Health Inc Commercial	$116.94
Rate for Payer: Group Health Inc Medicare	$81.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$116.94
Rate for Payer: Hamaspik Choice Inc Medicare	$116.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$152.03

ZZ CATH/GUIDING/MPA/8F/90CM

Facility IP

$233.89

Service Code	HCPCS C1725
Hospital Charge Code	41569396
Hospital Revenue Code	278
Min. Negotiated Rate	$116.94
Max. Negotiated Rate	$116.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$116.94
Rate for Payer: Hamaspik Choice Inc Medicare	$116.94

ZZ CATH/GUIDING/MPA/8F/90CM

Facility OP

$233.89

Service Code	HCPCS C1725
Hospital Charge Code	41569396
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$245.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$128.64
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	$116.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.49
Rate for Payer: Fidelis Medicare Advantage	$245.58
Rate for Payer: Group Health Inc Commercial	$116.94
Rate for Payer: Group Health Inc Medicare	$81.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$116.94
Rate for Payer: Hamaspik Choice Inc Medicare	$116.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$152.03

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

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569397
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/HIH/4F/.035/65CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569397
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/HIH/5F/.035/100CM

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569399
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/HIH/5F/.035/100CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569399
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/HIH/5F/.035/65CM

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569398
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/HIH/5F/.035/65CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569398
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/HIH/6.5F/.035/65CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569400
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/HIH/6.5F/.035/65CM

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569400
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/HOPKINS EMBOLECTOMY

Facility OP

$39.33

Service Code	HCPCS C1725
Hospital Charge Code	41569401
Hospital Revenue Code	278
Min. Negotiated Rate	$13.77
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.63
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	$19.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.61
Rate for Payer: Fidelis Medicare Advantage	$41.30
Rate for Payer: Group Health Inc Commercial	$19.66
Rate for Payer: Group Health Inc Medicare	$13.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.66
Rate for Payer: Hamaspik Choice Inc Medicare	$19.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$25.56

ZZ CATH/HOPKINS EMBOLECTOMY

Facility IP

$39.33

Service Code	HCPCS C1725
Hospital Charge Code	41569401
Hospital Revenue Code	278
Min. Negotiated Rate	$19.66
Max. Negotiated Rate	$19.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.66
Rate for Payer: Hamaspik Choice Inc Medicare	$19.66

ZZ CATH INT N3 B NT 100

Facility OP

$114.11

Service Code	HCPCS C1725
Hospital Charge Code	41567185
Hospital Revenue Code	278
Min. Negotiated Rate	$39.94
Max. Negotiated Rate	$119.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.76
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	$57.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.61
Rate for Payer: Fidelis Medicare Advantage	$119.82
Rate for Payer: Group Health Inc Commercial	$57.06
Rate for Payer: Group Health Inc Medicare	$39.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.06
Rate for Payer: Hamaspik Choice Inc Medicare	$57.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$74.17

ZZ CATH INT N3 B NT 100

Facility IP

$114.11

Service Code	HCPCS C1725
Hospital Charge Code	41567185
Hospital Revenue Code	278
Min. Negotiated Rate	$57.06
Max. Negotiated Rate	$57.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.06
Rate for Payer: Hamaspik Choice Inc Medicare	$57.06

ZZ CATH INT N3 B NT 80

Facility IP

$114.11

Service Code	HCPCS C1725
Hospital Charge Code	41567186
Hospital Revenue Code	278
Min. Negotiated Rate	$57.06
Max. Negotiated Rate	$57.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.06
Rate for Payer: Hamaspik Choice Inc Medicare	$57.06

ZZ CATH INT N3 B NT 80

Facility OP

$114.11

Service Code	HCPCS C1725
Hospital Charge Code	41567186
Hospital Revenue Code	278
Min. Negotiated Rate	$39.94
Max. Negotiated Rate	$119.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.76
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	$57.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.61
Rate for Payer: Fidelis Medicare Advantage	$119.82
Rate for Payer: Group Health Inc Commercial	$57.06
Rate for Payer: Group Health Inc Medicare	$39.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.06
Rate for Payer: Hamaspik Choice Inc Medicare	$57.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$74.17

ZZ CATH/KUMPER/5.5/.038/40CM

Facility OP

$32.32

Hospital Charge Code	41569402
Hospital Revenue Code	270
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$25.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.16
Rate for Payer: Aetna Government	$16.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.98
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

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