St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ CATH OMNIFLUSH 5FR 038-65

Facility IP

$45.08

Service Code	HCPCS C1725
Hospital Charge Code	41569670
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 CATH OMNIFLUSH 5FR 038-90

Facility IP

$42.24

Service Code	HCPCS C1725
Hospital Charge Code	41569671
Hospital Revenue Code	278
Min. Negotiated Rate	$21.12
Max. Negotiated Rate	$21.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.12
Rate for Payer: Hamaspik Choice Inc Medicare	$21.12

ZZ CATH OMNIFLUSH 5FR 038-90

Facility OP

$42.24

Service Code	HCPCS C1725
Hospital Charge Code	41569671
Hospital Revenue Code	278
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.23
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	$21.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.29
Rate for Payer: Fidelis Medicare Advantage	$44.35
Rate for Payer: Group Health Inc Commercial	$21.12
Rate for Payer: Group Health Inc Medicare	$14.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.12
Rate for Payer: Hamaspik Choice Inc Medicare	$21.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$27.46

ZZ CATH PIG CAVA 5FR 035-70

Facility IP

$85.76

Service Code	HCPCS C1725
Hospital Charge Code	41569700
Hospital Revenue Code	278
Min. Negotiated Rate	$42.88
Max. Negotiated Rate	$42.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.88
Rate for Payer: Hamaspik Choice Inc Medicare	$42.88

ZZ CATH PIG CAVA 5FR 035-70

Facility OP

$85.76

Service Code	HCPCS C1725
Hospital Charge Code	41569700
Hospital Revenue Code	278
Min. Negotiated Rate	$30.02
Max. Negotiated Rate	$90.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.17
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	$42.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.31
Rate for Payer: Fidelis Medicare Advantage	$90.05
Rate for Payer: Group Health Inc Commercial	$42.88
Rate for Payer: Group Health Inc Medicare	$30.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.88
Rate for Payer: Hamaspik Choice Inc Medicare	$42.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$55.74

ZZ CATH PIG CAVA 5FR 035-90

Facility OP

$85.76

Service Code	HCPCS C1725
Hospital Charge Code	41569701
Hospital Revenue Code	278
Min. Negotiated Rate	$30.02
Max. Negotiated Rate	$90.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.17
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	$42.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.31
Rate for Payer: Fidelis Medicare Advantage	$90.05
Rate for Payer: Group Health Inc Commercial	$42.88
Rate for Payer: Group Health Inc Medicare	$30.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.88
Rate for Payer: Hamaspik Choice Inc Medicare	$42.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$55.74

ZZ CATH PIG CAVA 5FR 035-90

Facility IP

$85.76

Service Code	HCPCS C1725
Hospital Charge Code	41569701
Hospital Revenue Code	278
Min. Negotiated Rate	$42.88
Max. Negotiated Rate	$42.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.88
Rate for Payer: Hamaspik Choice Inc Medicare	$42.88

ZZ CATH/PIGSIZING/5F/35/70

Facility OP

$54.67

Service Code	HCPCS C1725
Hospital Charge Code	41569352
Hospital Revenue Code	278
Min. Negotiated Rate	$19.13
Max. Negotiated Rate	$57.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.07
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	$27.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.44
Rate for Payer: Fidelis Medicare Advantage	$57.40
Rate for Payer: Group Health Inc Commercial	$27.34
Rate for Payer: Group Health Inc Medicare	$19.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.34
Rate for Payer: Hamaspik Choice Inc Medicare	$27.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.54

ZZ CATH/PIGSIZING/5F/35/70

Facility IP

$54.67

Service Code	HCPCS C1725
Hospital Charge Code	41569352
Hospital Revenue Code	278
Min. Negotiated Rate	$27.34
Max. Negotiated Rate	$27.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.34
Rate for Payer: Hamaspik Choice Inc Medicare	$27.34

ZZ CATH/PIGTAIL/5F/.035/90CM

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569353
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/PIGTAIL/5F/.035/90CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569353
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 PIGTAIL 5FR 035-70CM

Facility OP

$46.78

Hospital Charge Code	41569725
Hospital Revenue Code	270
Min. Negotiated Rate	$16.37
Max. Negotiated Rate	$37.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.39
Rate for Payer: Aetna Government	$23.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.81
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

ZZ CATH/PIGTAIL/6F/.038/90CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569354
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/PIGTAIL/6F/.038/90CM

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569354
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/PIGTAIL/7F

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569351
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/PIGTAIL/7F

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569351
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/PIGTAIL/7F/.035/100C

Facility IP

$33.00

Service Code	HCPCS C1725
Hospital Charge Code	41569355
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50

ZZ CATH/PIGTAIL/7F/.035/100C

Facility OP

$33.00

Service Code	HCPCS C1725
Hospital Charge Code	41569355
Hospital Revenue Code	278
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.15
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	$16.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.98
Rate for Payer: Fidelis Medicare Advantage	$34.65
Rate for Payer: Group Health Inc Commercial	$16.50
Rate for Payer: Group Health Inc Medicare	$11.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.45

ZZ CATH/PIGTAIL/7F/HIGH PRE

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569356
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/PIGTAIL/7F/HIGH PRE

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569356
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/RC1/5F/.038/65CM

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569357
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/RC1/5F/.038/65CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569357
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/RCL/6F

Facility IP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569358
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/RCL/6F

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569358
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/RIM/5F/.035/65CM

Facility OP

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569359
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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