St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ CK FLIII INT S 4 35 13

Facility OP

$57.76

Hospital Charge Code	41567031
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

ZZ CK FLIII INT S 7 38 45

Facility OP

$119.78

Hospital Charge Code	41567024
Hospital Revenue Code	270
Min. Negotiated Rate	$41.92
Max. Negotiated Rate	$95.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$65.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$59.89
Rate for Payer: Aetna Government	$59.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$95.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.45
Rate for Payer: Group Health Inc Commercial	$59.89
Rate for Payer: Group Health Inc Medicare	$41.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.89
Rate for Payer: Hamaspik Choice Inc Medicare	$59.89

ZZ CK FLIII INT SET 4 3.5

Facility OP

$59.54

Hospital Charge Code	41567020
Hospital Revenue Code	270
Min. Negotiated Rate	$20.84
Max. Negotiated Rate	$47.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.77
Rate for Payer: Aetna Government	$29.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.49
Rate for Payer: Group Health Inc Commercial	$29.77
Rate for Payer: Group Health Inc Medicare	$20.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.77
Rate for Payer: Hamaspik Choice Inc Medicare	$29.77

ZZ CK FLIII INT SET 6 35

Facility OP

$59.54

Hospital Charge Code	41567022
Hospital Revenue Code	270
Min. Negotiated Rate	$20.84
Max. Negotiated Rate	$47.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.77
Rate for Payer: Aetna Government	$29.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.49
Rate for Payer: Group Health Inc Commercial	$29.77
Rate for Payer: Group Health Inc Medicare	$20.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.77
Rate for Payer: Hamaspik Choice Inc Medicare	$29.77

ZZ CK FLIII INT ST 5 18 5

Facility OP

$74.07

Hospital Charge Code	41567025
Hospital Revenue Code	270
Min. Negotiated Rate	$25.92
Max. Negotiated Rate	$59.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$40.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.04
Rate for Payer: Aetna Government	$37.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$59.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.37
Rate for Payer: Group Health Inc Commercial	$37.04
Rate for Payer: Group Health Inc Medicare	$25.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.04
Rate for Payer: Hamaspik Choice Inc Medicare	$37.04

ZZ CK FLIII INT ST 5 35 5

Facility OP

$59.54

Hospital Charge Code	41567021
Hospital Revenue Code	270
Min. Negotiated Rate	$20.84
Max. Negotiated Rate	$47.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.77
Rate for Payer: Aetna Government	$29.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.49
Rate for Payer: Group Health Inc Commercial	$29.77
Rate for Payer: Group Health Inc Medicare	$20.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.77
Rate for Payer: Hamaspik Choice Inc Medicare	$29.77

ZZ CK FLIII INT ST 5.5 38

Facility OP

$53.16

Hospital Charge Code	41567027
Hospital Revenue Code	270
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$42.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.58
Rate for Payer: Aetna Government	$26.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.15
Rate for Payer: Group Health Inc Commercial	$26.58
Rate for Payer: Group Health Inc Medicare	$18.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.58
Rate for Payer: Hamaspik Choice Inc Medicare	$26.58

ZZ CK FLIII INT ST 6 18 5

Facility OP

$74.07

Hospital Charge Code	41567026
Hospital Revenue Code	270
Min. Negotiated Rate	$25.92
Max. Negotiated Rate	$59.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$40.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.04
Rate for Payer: Aetna Government	$37.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$59.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.37
Rate for Payer: Group Health Inc Commercial	$37.04
Rate for Payer: Group Health Inc Medicare	$25.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.04
Rate for Payer: Hamaspik Choice Inc Medicare	$37.04

ZZ CK FLIII INT ST 6 35 5

Facility OP

$57.76

Hospital Charge Code	41567023
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

ZZ CK FLIII INT ST 6.5 38

Facility OP

$53.16

Hospital Charge Code	41567028
Hospital Revenue Code	270
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$42.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.58
Rate for Payer: Aetna Government	$26.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.15
Rate for Payer: Group Health Inc Commercial	$26.58
Rate for Payer: Group Health Inc Medicare	$18.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.58
Rate for Payer: Hamaspik Choice Inc Medicare	$26.58

ZZ CK FLIII INT ST 7.5 38

Facility OP

$53.16

Hospital Charge Code	41567029
Hospital Revenue Code	270
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$42.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.58
Rate for Payer: Aetna Government	$26.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.15
Rate for Payer: Group Health Inc Commercial	$26.58
Rate for Payer: Group Health Inc Medicare	$18.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.58
Rate for Payer: Hamaspik Choice Inc Medicare	$26.58

ZZ CK FLWIII INTR SET 8.5 38

Facility OP

$53.16

Hospital Charge Code	41567030
Hospital Revenue Code	270
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$42.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.58
Rate for Payer: Aetna Government	$26.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.15
Rate for Payer: Group Health Inc Commercial	$26.58
Rate for Payer: Group Health Inc Medicare	$18.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.58
Rate for Payer: Hamaspik Choice Inc Medicare	$26.58

ZZ CLAMPLESS/10F/TRIPLE LUMEN

Facility OP

$2,360.14

Hospital Charge Code	41569043
Hospital Revenue Code	270
Min. Negotiated Rate	$826.05
Max. Negotiated Rate	$1,888.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,298.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,180.07
Rate for Payer: Aetna Government	$1,180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,888.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,604.90
Rate for Payer: Group Health Inc Commercial	$1,180.07
Rate for Payer: Group Health Inc Medicare	$826.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,180.07
Rate for Payer: Hamaspik Choice Inc Medicare	$1,180.07

ZZ CLAMPLESS/6/DL PICC/60CM

Facility OP

$1,169.44

Hospital Charge Code	41569044
Hospital Revenue Code	270
Min. Negotiated Rate	$409.30
Max. Negotiated Rate	$935.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$643.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$584.72
Rate for Payer: Aetna Government	$584.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$935.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$795.22
Rate for Payer: Group Health Inc Commercial	$584.72
Rate for Payer: Group Health Inc Medicare	$409.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$584.72
Rate for Payer: Hamaspik Choice Inc Medicare	$584.72

ZZ CLASS BAL 6-2.5/4.8/75

Facility OP

$586.85

Hospital Charge Code	41567264
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BAL 9-4/5/75

Facility OP

$635.75

Hospital Charge Code	41567259
Hospital Revenue Code	270
Min. Negotiated Rate	$222.51
Max. Negotiated Rate	$508.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$349.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$317.88
Rate for Payer: Aetna Government	$317.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$508.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$432.31
Rate for Payer: Group Health Inc Commercial	$317.88
Rate for Payer: Group Health Inc Medicare	$222.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$317.88
Rate for Payer: Hamaspik Choice Inc Medicare	$317.88

ZZ CLASS BALL 5-4/4.8/120

Facility OP

$635.75

Hospital Charge Code	41567266
Hospital Revenue Code	270
Min. Negotiated Rate	$222.51
Max. Negotiated Rate	$508.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$349.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$317.88
Rate for Payer: Aetna Government	$317.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$508.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$432.31
Rate for Payer: Group Health Inc Commercial	$317.88
Rate for Payer: Group Health Inc Medicare	$222.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$317.88
Rate for Payer: Hamaspik Choice Inc Medicare	$317.88

ZZ CLASS BALL 6-4/4.8/75

Facility OP

$586.85

Hospital Charge Code	41567265
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BALL 7-2.5/5/75

Facility OP

$586.85

Hospital Charge Code	41567262
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BALL 7-4/5/75

Facility OP

$586.85

Hospital Charge Code	41567263
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BALL 8-4/5/75

Facility OP

$586.85

Hospital Charge Code	41567261
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BL 5-2.5/4.8/75

Facility OP

$586.85

Hospital Charge Code	41567267
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BL 8-2.5/5/75

Facility OP

$586.85

Hospital Charge Code	41567260
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CNCT TUB END 14 30 ST

Facility OP

$25.16

Hospital Charge Code	41567293
Hospital Revenue Code	270
Min. Negotiated Rate	$8.81
Max. Negotiated Rate	$20.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.58
Rate for Payer: Aetna Government	$12.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.11
Rate for Payer: Group Health Inc Commercial	$12.58
Rate for Payer: Group Health Inc Medicare	$8.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.58
Rate for Payer: Hamaspik Choice Inc Medicare	$12.58

ZZ COAX QK CR NDL 20 9 20

Facility OP

$120.49

Hospital Charge Code	41567084
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

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