St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ DILATOR/VASCULAR/10F

Facility OP

$42.53

Hospital Charge Code	41569416
Hospital Revenue Code	270
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$34.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.26
Rate for Payer: Aetna Government	$21.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.92
Rate for Payer: Group Health Inc Commercial	$21.26
Rate for Payer: Group Health Inc Medicare	$14.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.26
Rate for Payer: Hamaspik Choice Inc Medicare	$21.26

ZZ DILATOR/VASCULAR/4F

Facility OP

$10.83

Hospital Charge Code	41569409
Hospital Revenue Code	270
Min. Negotiated Rate	$3.79
Max. Negotiated Rate	$8.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.42
Rate for Payer: Aetna Government	$5.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.36
Rate for Payer: Group Health Inc Commercial	$5.42
Rate for Payer: Group Health Inc Medicare	$3.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.42
Rate for Payer: Hamaspik Choice Inc Medicare	$5.42

ZZ DILATOR/VASCULAR/5F

Facility OP

$8.76

Hospital Charge Code	41569410
Hospital Revenue Code	270
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$7.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.38
Rate for Payer: Aetna Government	$4.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.96
Rate for Payer: Group Health Inc Commercial	$4.38
Rate for Payer: Group Health Inc Medicare	$3.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.38
Rate for Payer: Hamaspik Choice Inc Medicare	$4.38

ZZ DILATOR/VASCULAR/6F

Facility OP

$44.66

Hospital Charge Code	41569411
Hospital Revenue Code	270
Min. Negotiated Rate	$15.63
Max. Negotiated Rate	$35.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.33
Rate for Payer: Aetna Government	$22.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.37
Rate for Payer: Group Health Inc Commercial	$22.33
Rate for Payer: Group Health Inc Medicare	$15.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.33
Rate for Payer: Hamaspik Choice Inc Medicare	$22.33

ZZ DILATOR/VASCULAR/7F

Facility OP

$42.53

Hospital Charge Code	41569412
Hospital Revenue Code	270
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$34.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.26
Rate for Payer: Aetna Government	$21.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.92
Rate for Payer: Group Health Inc Commercial	$21.26
Rate for Payer: Group Health Inc Medicare	$14.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.26
Rate for Payer: Hamaspik Choice Inc Medicare	$21.26

ZZ DILATOR/VASCULAR/8F

Facility OP

$42.53

Hospital Charge Code	41569413
Hospital Revenue Code	270
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$34.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.26
Rate for Payer: Aetna Government	$21.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.92
Rate for Payer: Group Health Inc Commercial	$21.26
Rate for Payer: Group Health Inc Medicare	$14.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.26
Rate for Payer: Hamaspik Choice Inc Medicare	$21.26

ZZ DILATOR/VASCULAR/DES-HOF/4F

Facility OP

$51.57

Hospital Charge Code	41569414
Hospital Revenue Code	270
Min. Negotiated Rate	$18.05
Max. Negotiated Rate	$41.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.78
Rate for Payer: Aetna Government	$25.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.07
Rate for Payer: Group Health Inc Commercial	$25.78
Rate for Payer: Group Health Inc Medicare	$18.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.78
Rate for Payer: Hamaspik Choice Inc Medicare	$25.78

ZZ DILATOR/VASCULAR/SADDELENI/5F

Facility OP

$28.18

Hospital Charge Code	41569415
Hospital Revenue Code	270
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$22.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.09
Rate for Payer: Aetna Government	$14.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.16
Rate for Payer: Group Health Inc Commercial	$14.09
Rate for Payer: Group Health Inc Medicare	$9.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.09
Rate for Payer: Hamaspik Choice Inc Medicare	$14.09

ZZ DISP CHIBA NDL 18G/10CM

Facility OP

$34.02

Hospital Charge Code	41569715
Hospital Revenue Code	270
Min. Negotiated Rate	$11.91
Max. Negotiated Rate	$27.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.01
Rate for Payer: Aetna Government	$17.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.13
Rate for Payer: Group Health Inc Commercial	$17.01
Rate for Payer: Group Health Inc Medicare	$11.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.01
Rate for Payer: Hamaspik Choice Inc Medicare	$17.01

ZZ DISP CHIBA NDL 18G/15CM

Facility OP

$32.60

Hospital Charge Code	41569716
Hospital Revenue Code	270
Min. Negotiated Rate	$11.41
Max. Negotiated Rate	$26.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.30
Rate for Payer: Aetna Government	$16.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.17
Rate for Payer: Group Health Inc Commercial	$16.30
Rate for Payer: Group Health Inc Medicare	$11.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.30
Rate for Payer: Hamaspik Choice Inc Medicare	$16.30

ZZ DISP CHIBA NDL 18G/20CM

Facility OP

$32.60

Hospital Charge Code	41569717
Hospital Revenue Code	270
Min. Negotiated Rate	$11.41
Max. Negotiated Rate	$26.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.30
Rate for Payer: Aetna Government	$16.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.17
Rate for Payer: Group Health Inc Commercial	$16.30
Rate for Payer: Group Health Inc Medicare	$11.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.30
Rate for Payer: Hamaspik Choice Inc Medicare	$16.30

ZZ DISP CHIBA NDL 20G/10CM

Facility OP

$32.60

Hospital Charge Code	41569718
Hospital Revenue Code	270
Min. Negotiated Rate	$11.41
Max. Negotiated Rate	$26.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.30
Rate for Payer: Aetna Government	$16.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.17
Rate for Payer: Group Health Inc Commercial	$16.30
Rate for Payer: Group Health Inc Medicare	$11.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.30
Rate for Payer: Hamaspik Choice Inc Medicare	$16.30

ZZ DISP CHIBA NDL 20G/15CM

Facility OP

$32.60

Hospital Charge Code	41569719
Hospital Revenue Code	270
Min. Negotiated Rate	$11.41
Max. Negotiated Rate	$26.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.30
Rate for Payer: Aetna Government	$16.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.17
Rate for Payer: Group Health Inc Commercial	$16.30
Rate for Payer: Group Health Inc Medicare	$11.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.30
Rate for Payer: Hamaspik Choice Inc Medicare	$16.30

ZZ DISP CHIBA NDL 22G/15CM

Facility OP

$32.60

Hospital Charge Code	41569721
Hospital Revenue Code	270
Min. Negotiated Rate	$11.41
Max. Negotiated Rate	$26.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.30
Rate for Payer: Aetna Government	$16.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.17
Rate for Payer: Group Health Inc Commercial	$16.30
Rate for Payer: Group Health Inc Medicare	$11.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.30
Rate for Payer: Hamaspik Choice Inc Medicare	$16.30

ZZ DISPOS CHIBA NDL 21 10

Facility OP

$21.98

Hospital Charge Code	41567085
Hospital Revenue Code	270
Min. Negotiated Rate	$7.69
Max. Negotiated Rate	$17.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.99
Rate for Payer: Aetna Government	$10.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.95
Rate for Payer: Group Health Inc Commercial	$10.99
Rate for Payer: Group Health Inc Medicare	$7.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.99
Rate for Payer: Hamaspik Choice Inc Medicare	$10.99

ZZ DISPOS CHIBA NDL 21 15

Facility OP

$21.98

Hospital Charge Code	41567086
Hospital Revenue Code	270
Min. Negotiated Rate	$7.69
Max. Negotiated Rate	$17.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.99
Rate for Payer: Aetna Government	$10.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.95
Rate for Payer: Group Health Inc Commercial	$10.99
Rate for Payer: Group Health Inc Medicare	$7.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.99
Rate for Payer: Hamaspik Choice Inc Medicare	$10.99

ZZ DISPOS CHIBA NDL 22 10

Facility OP

$21.98

Hospital Charge Code	41567087
Hospital Revenue Code	270
Min. Negotiated Rate	$7.69
Max. Negotiated Rate	$17.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.99
Rate for Payer: Aetna Government	$10.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.95
Rate for Payer: Group Health Inc Commercial	$10.99
Rate for Payer: Group Health Inc Medicare	$7.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.99
Rate for Payer: Hamaspik Choice Inc Medicare	$10.99

ZZ DISPOS CHIBA NDL 22 20

Facility OP

$21.98

Hospital Charge Code	41567088
Hospital Revenue Code	270
Min. Negotiated Rate	$7.69
Max. Negotiated Rate	$17.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.99
Rate for Payer: Aetna Government	$10.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.95
Rate for Payer: Group Health Inc Commercial	$10.99
Rate for Payer: Group Health Inc Medicare	$7.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.99
Rate for Payer: Hamaspik Choice Inc Medicare	$10.99

ZZ DISP TUMOR MASS NDL 18G/15CM

Facility OP

$58.83

Hospital Charge Code	41569720
Hospital Revenue Code	270
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$47.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.42
Rate for Payer: Aetna Government	$29.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.00
Rate for Payer: Group Health Inc Commercial	$29.42
Rate for Payer: Group Health Inc Medicare	$20.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.42
Rate for Payer: Hamaspik Choice Inc Medicare	$29.42

ZZ DISP VANSON BERG NDL 22G/25CM

Facility OP

$52.45

Hospital Charge Code	41569723
Hospital Revenue Code	270
Min. Negotiated Rate	$18.36
Max. Negotiated Rate	$41.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.22
Rate for Payer: Aetna Government	$26.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.67
Rate for Payer: Group Health Inc Commercial	$26.22
Rate for Payer: Group Health Inc Medicare	$18.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.22
Rate for Payer: Hamaspik Choice Inc Medicare	$26.22

ZZ DIS TIP WR W/HNDLE 38

Facility OP

$124.04

Hospital Charge Code	41567094
Hospital Revenue Code	270
Min. Negotiated Rate	$43.41
Max. Negotiated Rate	$99.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.02
Rate for Payer: Aetna Government	$62.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.35
Rate for Payer: Group Health Inc Commercial	$62.02
Rate for Payer: Group Health Inc Medicare	$43.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.02
Rate for Payer: Hamaspik Choice Inc Medicare	$62.02

ZZ DRAINAGE/ABCESS/THAL1600

Facility OP

$163.45

Service Code	HCPCS C1725
Hospital Charge Code	41569420
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$171.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.90
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	$81.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.98
Rate for Payer: Fidelis Medicare Advantage	$171.62
Rate for Payer: Group Health Inc Commercial	$81.72
Rate for Payer: Group Health Inc Medicare	$57.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.72
Rate for Payer: Hamaspik Choice Inc Medicare	$81.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.24

ZZ DRAINAGE/ABCESS/THAL1600

Facility IP

$163.45

Service Code	HCPCS C1725
Hospital Charge Code	41569420
Hospital Revenue Code	278
Min. Negotiated Rate	$81.72
Max. Negotiated Rate	$81.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.72
Rate for Payer: Hamaspik Choice Inc Medicare	$81.72

ZZ DRAINAGE/ABCESS/THAL2400

Facility IP

$163.45

Service Code	HCPCS C1725
Hospital Charge Code	41569419
Hospital Revenue Code	278
Min. Negotiated Rate	$81.72
Max. Negotiated Rate	$81.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.72
Rate for Payer: Hamaspik Choice Inc Medicare	$81.72

ZZ DRAINAGE/ABCESS/THAL2400

Facility OP

$163.45

Service Code	HCPCS C1725
Hospital Charge Code	41569419
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$171.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.90
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	$81.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.98
Rate for Payer: Fidelis Medicare Advantage	$171.62
Rate for Payer: Group Health Inc Commercial	$81.72
Rate for Payer: Group Health Inc Medicare	$57.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.72
Rate for Payer: Hamaspik Choice Inc Medicare	$81.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.24

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