St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ CATH TEGT 150/4 5FR 038-70

Facility IP

$85.76

Service Code	HCPCS C1725
Hospital Charge Code	41569667
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 TEGT 150/4 5FR 038-70

Facility OP

$85.76

Service Code	HCPCS C1725
Hospital Charge Code	41569667
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 THROBECTOMY/EMBO SEP 8

Facility OP

$3,990.00

Service Code	HCPCS C1757
Hospital Charge Code	41563141
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$4,189.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,194.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.33
Rate for Payer: Aetna Government	$16.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,995.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,294.25
Rate for Payer: Fidelis Medicare Advantage	$4,189.50
Rate for Payer: Group Health Inc Commercial	$1,995.00
Rate for Payer: Group Health Inc Medicare	$1,396.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,995.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,995.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,593.50

ZZ CATH THROBECTOMY/EMBO SEP 8

Facility IP

$3,990.00

Service Code	HCPCS C1757
Hospital Charge Code	41563141
Hospital Revenue Code	278
Min. Negotiated Rate	$1,995.00
Max. Negotiated Rate	$1,995.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,995.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,995.00

ZZ CATH VISCERAL SELEC 5FR 038-80

Facility OP

$50.33

Hospital Charge Code	41569702
Hospital Revenue Code	270
Min. Negotiated Rate	$17.62
Max. Negotiated Rate	$40.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.16
Rate for Payer: Aetna Government	$25.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.22
Rate for Payer: Group Health Inc Commercial	$25.16
Rate for Payer: Group Health Inc Medicare	$17.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.16
Rate for Payer: Hamaspik Choice Inc Medicare	$25.16

ZZ CAX QK CR NDL 20 15 20

Facility OP

$120.49

Hospital Charge Code	41567083
Hospital Revenue Code	270
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$96.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.24
Rate for Payer: Aetna Government	$60.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$96.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.93
Rate for Payer: Group Health Inc Commercial	$60.24
Rate for Payer: Group Health Inc Medicare	$42.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.24
Rate for Payer: Hamaspik Choice Inc Medicare	$60.24

ZZ CELERO BIOPSY DEVICE (VAC-ASSI

Facility OP

$450.00

Hospital Charge Code	41568617
Hospital Revenue Code	270
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$360.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$225.00
Rate for Payer: Aetna Government	$225.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$360.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$306.00
Rate for Payer: Group Health Inc Commercial	$225.00
Rate for Payer: Group Health Inc Medicare	$157.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.00
Rate for Payer: Hamaspik Choice Inc Medicare	$225.00

ZZ CELERO INTRODUCER 12 GA

Facility OP

$38.00

Hospital Charge Code	41568618
Hospital Revenue Code	270
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$30.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.00
Rate for Payer: Aetna Government	$19.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.84
Rate for Payer: Group Health Inc Commercial	$19.00
Rate for Payer: Group Health Inc Medicare	$13.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.00
Rate for Payer: Hamaspik Choice Inc Medicare	$19.00

ZZ CELERO TISSUE MARKING SYSTEM

Facility OP

$150.00

Hospital Charge Code	41568619
Hospital Revenue Code	270
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

ZZ CENT BALL 8/4/75

Facility OP

$722.93

Hospital Charge Code	41569770
Hospital Revenue Code	270
Min. Negotiated Rate	$253.03
Max. Negotiated Rate	$578.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$397.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$361.46
Rate for Payer: Aetna Government	$361.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$578.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$491.59
Rate for Payer: Group Health Inc Commercial	$361.46
Rate for Payer: Group Health Inc Medicare	$253.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$361.46
Rate for Payer: Hamaspik Choice Inc Medicare	$361.46

ZZ CENTRAL VENOUS/10F INTRO KIT

Facility OP

$112.70

Hospital Charge Code	41569525
Hospital Revenue Code	270
Min. Negotiated Rate	$39.44
Max. Negotiated Rate	$90.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.35
Rate for Payer: Aetna Government	$56.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.64
Rate for Payer: Group Health Inc Commercial	$56.35
Rate for Payer: Group Health Inc Medicare	$39.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.35
Rate for Payer: Hamaspik Choice Inc Medicare	$56.35

ZZ CENTRAL VENOUS/14F INTRO KIT

Facility OP

$112.70

Hospital Charge Code	41569526
Hospital Revenue Code	270
Min. Negotiated Rate	$39.44
Max. Negotiated Rate	$90.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.35
Rate for Payer: Aetna Government	$56.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.64
Rate for Payer: Group Health Inc Commercial	$56.35
Rate for Payer: Group Health Inc Medicare	$39.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.35
Rate for Payer: Hamaspik Choice Inc Medicare	$56.35

ZZ CENTRAL VENOUS/BROVIAL/6.6F/SL

Facility OP

$333.83

Hospital Charge Code	41569033
Hospital Revenue Code	270
Min. Negotiated Rate	$116.84
Max. Negotiated Rate	$267.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$166.92
Rate for Payer: Aetna Government	$166.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$267.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$227.00
Rate for Payer: Group Health Inc Commercial	$166.92
Rate for Payer: Group Health Inc Medicare	$116.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.92
Rate for Payer: Hamaspik Choice Inc Medicare	$166.92

ZZ CENTRAL VENOUS CATH. KIT

Facility OP

$34.00

Hospital Charge Code	41568747
Hospital Revenue Code	270
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$27.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.00
Rate for Payer: Aetna Government	$17.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.12
Rate for Payer: Group Health Inc Commercial	$17.00
Rate for Payer: Group Health Inc Medicare	$11.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.00
Rate for Payer: Hamaspik Choice Inc Medicare	$17.00

ZZ CENTRAL VENOUS/HICKMAN/36CM

Facility OP

$440.14

Hospital Charge Code	41569527
Hospital Revenue Code	270
Min. Negotiated Rate	$154.05
Max. Negotiated Rate	$352.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$242.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$220.07
Rate for Payer: Aetna Government	$220.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$352.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.30
Rate for Payer: Group Health Inc Commercial	$220.07
Rate for Payer: Group Health Inc Medicare	$154.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$220.07
Rate for Payer: Hamaspik Choice Inc Medicare	$220.07

ZZ CENTRAL VENOUS/HICKMAN/40CM

Facility OP

$440.14

Hospital Charge Code	41569528
Hospital Revenue Code	270
Min. Negotiated Rate	$154.05
Max. Negotiated Rate	$352.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$242.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$220.07
Rate for Payer: Aetna Government	$220.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$352.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.30
Rate for Payer: Group Health Inc Commercial	$220.07
Rate for Payer: Group Health Inc Medicare	$154.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$220.07
Rate for Payer: Hamaspik Choice Inc Medicare	$220.07

ZZ CENTRAL VENOUS/HICKMAN/45CM

Facility OP

$427.38

Hospital Charge Code	41569036
Hospital Revenue Code	270
Min. Negotiated Rate	$149.58
Max. Negotiated Rate	$341.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$213.69
Rate for Payer: Aetna Government	$213.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$341.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$290.62
Rate for Payer: Group Health Inc Commercial	$213.69
Rate for Payer: Group Health Inc Medicare	$149.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$213.69
Rate for Payer: Hamaspik Choice Inc Medicare	$213.69

ZZ CENTRAL VENOUS/HICKMAN/50CM

Facility OP

$444.39

Hospital Charge Code	41569037
Hospital Revenue Code	270
Min. Negotiated Rate	$155.54
Max. Negotiated Rate	$355.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$244.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$222.20
Rate for Payer: Aetna Government	$222.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$355.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$302.19
Rate for Payer: Group Health Inc Commercial	$222.20
Rate for Payer: Group Health Inc Medicare	$155.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$222.20
Rate for Payer: Hamaspik Choice Inc Medicare	$222.20

ZZ CENTRAL VENOUS/LEONARD

Facility OP

$393.36

Hospital Charge Code	41569038
Hospital Revenue Code	270
Min. Negotiated Rate	$137.68
Max. Negotiated Rate	$314.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$196.68
Rate for Payer: Aetna Government	$196.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$314.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$267.48
Rate for Payer: Group Health Inc Commercial	$196.68
Rate for Payer: Group Health Inc Medicare	$137.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68

ZZ CENTRAL VENOUS/REPAIR KIT/HICK

Facility OP

$148.84

Hospital Charge Code	41569040
Hospital Revenue Code	270
Min. Negotiated Rate	$52.09
Max. Negotiated Rate	$119.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$74.42
Rate for Payer: Aetna Government	$74.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$119.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$101.21
Rate for Payer: Group Health Inc Commercial	$74.42
Rate for Payer: Group Health Inc Medicare	$52.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.42
Rate for Payer: Hamaspik Choice Inc Medicare	$74.42

ZZ CENTRAL VENOUS/REPAIR KIT/LEN

Facility OP

$219.01

Hospital Charge Code	41569039
Hospital Revenue Code	270
Min. Negotiated Rate	$76.65
Max. Negotiated Rate	$175.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$120.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$109.50
Rate for Payer: Aetna Government	$109.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$175.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$148.93
Rate for Payer: Group Health Inc Commercial	$109.50
Rate for Payer: Group Health Inc Medicare	$76.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.50
Rate for Payer: Hamaspik Choice Inc Medicare	$109.50

ZZ CENTRAL VENOUS/REPAIR KIT/LFD

Facility OP

$150.97

Hospital Charge Code	41569041
Hospital Revenue Code	270
Min. Negotiated Rate	$52.84
Max. Negotiated Rate	$120.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$83.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.48
Rate for Payer: Aetna Government	$75.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.66
Rate for Payer: Group Health Inc Commercial	$75.48
Rate for Payer: Group Health Inc Medicare	$52.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.48
Rate for Payer: Hamaspik Choice Inc Medicare	$75.48

ZZ CENTURION SORBAVIEW 2000

Facility OP

$3.16

Hospital Charge Code	41561893
Hospital Revenue Code	270
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$2.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.58
Rate for Payer: Aetna Government	$1.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.15
Rate for Payer: Group Health Inc Commercial	$1.58
Rate for Payer: Group Health Inc Medicare	$1.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1.58

ZZ CHEMO-PORT SMALL TITANIUM

Facility OP

$893.03

Hospital Charge Code	41569815
Hospital Revenue Code	270
Min. Negotiated Rate	$312.56
Max. Negotiated Rate	$714.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$491.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$446.52
Rate for Payer: Aetna Government	$446.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$714.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$607.26
Rate for Payer: Group Health Inc Commercial	$446.52
Rate for Payer: Group Health Inc Medicare	$312.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$446.52
Rate for Payer: Hamaspik Choice Inc Medicare	$446.52

ZZ CK FLIII INT 4.5 35 13

Facility OP

$57.76

Hospital Charge Code	41567032
Hospital Revenue Code	270
Min. Negotiated Rate	$20.22
Max. Negotiated Rate	$46.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.88
Rate for Payer: Aetna Government	$28.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.28
Rate for Payer: Group Health Inc Commercial	$28.88
Rate for Payer: Group Health Inc Medicare	$20.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.88
Rate for Payer: Hamaspik Choice Inc Medicare	$28.88

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