St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ DRAINAGE/APD/10F LOCKING

Facility OP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569421
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
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	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/10F LOCKING

Facility IP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569421
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/10F NONLOCKING

Facility OP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569422
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
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	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/10F NONLOCKING

Facility IP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569422
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/12F LOCKING

Facility OP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569423
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
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	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/12F LOCKING

Facility IP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569423
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/12F NONLOCKING

Facility OP

$150.97

Service Code	HCPCS C1725
Hospital Charge Code	41569424
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$158.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$83.03
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	$75.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.81
Rate for Payer: Fidelis Medicare Advantage	$158.52
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$98.13

ZZ DRAINAGE/APD/12F NONLOCKING

Facility IP

$150.97

Service Code	HCPCS C1725
Hospital Charge Code	41569424
Hospital Revenue Code	278
Min. Negotiated Rate	$75.48
Max. Negotiated Rate	$75.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.48
Rate for Payer: Hamaspik Choice Inc Medicare	$75.48

ZZ DRAINAGE/APD/14F LOCKING

Facility IP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569425
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/14F LOCKING

Facility OP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569425
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
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	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/8F LOCKING

Facility OP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569426
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
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	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/8F LOCKING

Facility IP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569426
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/8F NON LOCKING

Facility OP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569427
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
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	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/8F NON LOCKING

Facility IP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569427
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/BILIARY/8.5F/CAMLOC

Facility IP

$158.81

Service Code	HCPCS C1725
Hospital Charge Code	41569430
Hospital Revenue Code	278
Min. Negotiated Rate	$79.40
Max. Negotiated Rate	$79.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.40
Rate for Payer: Hamaspik Choice Inc Medicare	$79.40

ZZ DRAINAGE/BILIARY/8.5F/CAMLOC

Facility OP

$158.81

Service Code	HCPCS C1725
Hospital Charge Code	41569430
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$166.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$87.35
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	$79.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$91.32
Rate for Payer: Fidelis Medicare Advantage	$166.75
Rate for Payer: Group Health Inc Commercial	$79.40
Rate for Payer: Group Health Inc Medicare	$55.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.40
Rate for Payer: Hamaspik Choice Inc Medicare	$79.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$103.23

ZZ DRAINAGE/BILIARY/ANCHOR/10F

Facility OP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569433
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
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	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/BILIARY/ANCHOR/10F

Facility IP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569433
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/BILIARY/ANCHOR/12F

Facility OP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569434
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
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	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/BILIARY/ANCHOR/12F

Facility IP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569434
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/BILIARY/ANCHOR/8F

Facility OP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569435
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
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	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/BILIARY/ANCHOR/8F

Facility IP

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569435
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE CATHETER 10F

Facility IP

$1,204.88

Service Code	HCPCS C1725
Hospital Charge Code	41569745
Hospital Revenue Code	278
Min. Negotiated Rate	$602.44
Max. Negotiated Rate	$602.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$602.44
Rate for Payer: Hamaspik Choice Inc Medicare	$602.44

ZZ DRAINAGE CATHETER 10F

Facility OP

$1,204.88

Service Code	HCPCS C1725
Hospital Charge Code	41569745
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$1,265.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$662.68
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	$602.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$692.81
Rate for Payer: Fidelis Medicare Advantage	$1,265.12
Rate for Payer: Group Health Inc Commercial	$602.44
Rate for Payer: Group Health Inc Medicare	$421.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$602.44
Rate for Payer: Hamaspik Choice Inc Medicare	$602.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$783.17

ZZ DRAINAGE CATHETER 12F

Facility OP

$1,204.88

Hospital Charge Code	41569746
Hospital Revenue Code	270
Min. Negotiated Rate	$421.71
Max. Negotiated Rate	$963.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$662.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$602.44
Rate for Payer: Aetna Government	$602.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$963.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$819.32
Rate for Payer: Group Health Inc Commercial	$602.44
Rate for Payer: Group Health Inc Medicare	$421.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$602.44
Rate for Payer: Hamaspik Choice Inc Medicare	$602.44

Price Transparency.

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