St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ COBRA (2) 4 65

Facility OP

$48.91

Hospital Charge Code	41567160
Hospital Revenue Code	270
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$39.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.46
Rate for Payer: Aetna Government	$24.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.26
Rate for Payer: Group Health Inc Commercial	$24.46
Rate for Payer: Group Health Inc Medicare	$17.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46

ZZ COBRA (2) 5 65

Facility OP

$48.91

Hospital Charge Code	41567161
Hospital Revenue Code	270
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$39.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.46
Rate for Payer: Aetna Government	$24.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.26
Rate for Payer: Group Health Inc Commercial	$24.46
Rate for Payer: Group Health Inc Medicare	$17.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46

ZZ COBRA 4.1FRX100 CATHETER

Facility OP

$55.00

Hospital Charge Code	41567744
Hospital Revenue Code	270
Min. Negotiated Rate	$19.25
Max. Negotiated Rate	$44.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.50
Rate for Payer: Aetna Government	$27.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.40
Rate for Payer: Group Health Inc Commercial	$27.50
Rate for Payer: Group Health Inc Medicare	$19.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.50
Rate for Payer: Hamaspik Choice Inc Medicare	$27.50

ZZ COIL/.018 HILAL

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41560050
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41560050
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/1.5-5

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569045
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/1.5-5

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569045
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/2-1-7

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569048
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/2-1-7

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569048
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/2-2

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569046
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/2-2

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569046
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/2-4

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569047
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/2-4

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569047
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/3-10

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569049
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/3-10

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569049
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/3-4

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569050
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/3-4

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569050
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/4-6

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569051
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/4-6

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569051
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/018 HILAL/4-7

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569052
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/018 HILAL/4-7

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569052
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/6-10

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569053
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/6-10

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569053
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/6-5

Facility IP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569054
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/6-5

Facility OP

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569054
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

Price Transparency.

All Charges