St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ EV3 INFUSION CATHETER

Facility IP

$230.00

Service Code	HCPCS C1725
Hospital Charge Code	41561930
Hospital Revenue Code	278
Min. Negotiated Rate	$115.00
Max. Negotiated Rate	$115.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

ZZ EV3 REBAR-027 MICRO CATH

Facility OP

$550.00

Hospital Charge Code	41564629
Hospital Revenue Code	272
Min. Negotiated Rate	$192.50
Max. Negotiated Rate	$440.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$302.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.00
Rate for Payer: Aetna Government	$275.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$440.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$374.00
Rate for Payer: Group Health Inc Commercial	$275.00
Rate for Payer: Group Health Inc Medicare	$192.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$275.00

ZZ EV3 REBAR-18 MICRO CATH

Facility OP

$730.00

Hospital Charge Code	41564627
Hospital Revenue Code	272
Min. Negotiated Rate	$255.50
Max. Negotiated Rate	$584.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$401.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$365.00
Rate for Payer: Aetna Government	$365.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$584.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$496.40
Rate for Payer: Group Health Inc Commercial	$365.00
Rate for Payer: Group Health Inc Medicare	$255.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$365.00
Rate for Payer: Hamaspik Choice Inc Medicare	$365.00

ZZ EV3 REBAR MICRO CATHETER

Facility OP

$1,500.00

Hospital Charge Code	41563153
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$825.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$750.00
Rate for Payer: Aetna Government	$750.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,020.00
Rate for Payer: Group Health Inc Commercial	$750.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$750.00

ZZ EV3 TRAILBLAZER CATHETER

Facility OP

$330.00

Hospital Charge Code	41561357
Hospital Revenue Code	272
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$264.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$165.00
Rate for Payer: Aetna Government	$165.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$264.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.40
Rate for Payer: Group Health Inc Commercial	$165.00
Rate for Payer: Group Health Inc Medicare	$115.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00
Rate for Payer: Hamaspik Choice Inc Medicare	$165.00

ZZ EXCHANGE WIRE 35 260J3

Facility OP

$54.93

Service Code	HCPCS C1769
Hospital Charge Code	41567131
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$57.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.58
Rate for Payer: Fidelis Medicare Advantage	$57.68
Rate for Payer: Group Health Inc Commercial	$27.46
Rate for Payer: Group Health Inc Medicare	$19.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.46
Rate for Payer: Hamaspik Choice Inc Medicare	$27.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.70

ZZ EXCHANGE WIRE 35 260J3

Facility IP

$54.93

Service Code	HCPCS C1769
Hospital Charge Code	41567131
Hospital Revenue Code	278
Min. Negotiated Rate	$27.46
Max. Negotiated Rate	$27.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.46
Rate for Payer: Hamaspik Choice Inc Medicare	$27.46

ZZ EXTENSION SET 30 #4610

Facility OP

$192.05

Hospital Charge Code	41569001
Hospital Revenue Code	270
Min. Negotiated Rate	$67.22
Max. Negotiated Rate	$153.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$105.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$96.02
Rate for Payer: Aetna Government	$96.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$153.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$130.59
Rate for Payer: Group Health Inc Commercial	$96.02
Rate for Payer: Group Health Inc Medicare	$67.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$96.02
Rate for Payer: Hamaspik Choice Inc Medicare	$96.02

ZZ EXTERNAL FEEDING TUBE ADAPTER

Facility OP

$7.23

Hospital Charge Code	41569497
Hospital Revenue Code	270
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$5.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.62
Rate for Payer: Aetna Government	$3.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.92
Rate for Payer: Group Health Inc Commercial	$3.62
Rate for Payer: Group Health Inc Medicare	$2.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.62
Rate for Payer: Hamaspik Choice Inc Medicare	$3.62

ZZ FASTRACKER 325 KIT MCT

Facility OP

$1,059.59

Hospital Charge Code	41567286
Hospital Revenue Code	270
Min. Negotiated Rate	$370.86
Max. Negotiated Rate	$847.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$582.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$529.80
Rate for Payer: Aetna Government	$529.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$847.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$720.52
Rate for Payer: Group Health Inc Commercial	$529.80
Rate for Payer: Group Health Inc Medicare	$370.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$529.80
Rate for Payer: Hamaspik Choice Inc Medicare	$529.80

ZZ FATHOM-16 STEERABLE GUIDE WIRE

Facility OP

$578.00

Hospital Charge Code	41569963
Hospital Revenue Code	279
Min. Negotiated Rate	$202.30
Max. Negotiated Rate	$462.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$317.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$289.00
Rate for Payer: Aetna Government	$289.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$462.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$393.04
Rate for Payer: Group Health Inc Commercial	$289.00
Rate for Payer: Group Health Inc Medicare	$202.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$289.00
Rate for Payer: Hamaspik Choice Inc Medicare	$289.00

ZZ FILTER/BIRDSNEST/FEMORAL

Facility OP

$1,807.85

Hospital Charge Code	41569498
Hospital Revenue Code	270
Min. Negotiated Rate	$632.75
Max. Negotiated Rate	$1,446.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$994.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$903.92
Rate for Payer: Aetna Government	$903.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,229.34
Rate for Payer: Group Health Inc Commercial	$903.92
Rate for Payer: Group Health Inc Medicare	$632.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$903.92
Rate for Payer: Hamaspik Choice Inc Medicare	$903.92

ZZ FILTER/BIRDSNEST/JUGULAR

Facility OP

$1,807.85

Hospital Charge Code	41569499
Hospital Revenue Code	270
Min. Negotiated Rate	$632.75
Max. Negotiated Rate	$1,446.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$994.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$903.92
Rate for Payer: Aetna Government	$903.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,229.34
Rate for Payer: Group Health Inc Commercial	$903.92
Rate for Payer: Group Health Inc Medicare	$632.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$903.92
Rate for Payer: Hamaspik Choice Inc Medicare	$903.92

ZZ FILTER/GREENFIELD SS/FEMORAL

Facility OP

$2,513.23

Service Code	HCPCS C1880
Hospital Charge Code	41569500
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$2,638.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,382.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,256.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,445.11
Rate for Payer: Fidelis Medicare Advantage	$2,638.89
Rate for Payer: Group Health Inc Commercial	$1,256.62
Rate for Payer: Group Health Inc Medicare	$879.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,256.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,633.60

ZZ FILTER/GREENFIELD SS/FEMORAL

Facility IP

$2,513.23

Service Code	HCPCS C1880
Hospital Charge Code	41569500
Hospital Revenue Code	278
Min. Negotiated Rate	$1,256.62
Max. Negotiated Rate	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,256.62

ZZ FILTER/GREENFIELD SS/JUNGULAR

Facility OP

$2,513.23

Service Code	HCPCS C1880
Hospital Charge Code	41569501
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$2,638.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,382.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,256.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,445.11
Rate for Payer: Fidelis Medicare Advantage	$2,638.89
Rate for Payer: Group Health Inc Commercial	$1,256.62
Rate for Payer: Group Health Inc Medicare	$879.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,256.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,633.60

ZZ FILTER/GREENFIELD SS/JUNGULAR

Facility IP

$2,513.23

Service Code	HCPCS C1880
Hospital Charge Code	41569501
Hospital Revenue Code	278
Min. Negotiated Rate	$1,256.62
Max. Negotiated Rate	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,256.62

ZZ FILTER/NITINOL/FEMORAL

Facility OP

$2,023.13

Service Code	HCPCS C1880
Hospital Charge Code	41569502
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$2,124.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,112.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,011.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,163.30
Rate for Payer: Fidelis Medicare Advantage	$2,124.29
Rate for Payer: Group Health Inc Commercial	$1,011.56
Rate for Payer: Group Health Inc Medicare	$708.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,011.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1,011.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,315.03

ZZ FILTER/NITINOL/FEMORAL

Facility IP

$2,023.13

Service Code	HCPCS C1880
Hospital Charge Code	41569502
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.56
Max. Negotiated Rate	$1,011.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,011.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1,011.56

ZZ FILTER/NITINOL/JUGULAR

Facility OP

$2,023.13

Service Code	HCPCS C1880
Hospital Charge Code	41569503
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$2,124.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,112.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,011.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,163.30
Rate for Payer: Fidelis Medicare Advantage	$2,124.29
Rate for Payer: Group Health Inc Commercial	$1,011.56
Rate for Payer: Group Health Inc Medicare	$708.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,011.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1,011.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,315.03

ZZ FILTER/NITINOL/JUGULAR

Facility IP

$2,023.13

Service Code	HCPCS C1880
Hospital Charge Code	41569503
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.56
Max. Negotiated Rate	$1,011.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,011.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1,011.56

ZZ FILTER SET FEMORAL APPROACH

Facility OP

$2,500.00

Hospital Charge Code	41568879
Hospital Revenue Code	270
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,375.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,250.00
Rate for Payer: Aetna Government	$1,250.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,700.00
Rate for Payer: Group Health Inc Commercial	$1,250.00
Rate for Payer: Group Health Inc Medicare	$875.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,250.00

ZZ FLEXCHFLO870

Facility IP

$164.29

Service Code	HCPCS C1725
Hospital Charge Code	41569814
Hospital Revenue Code	278
Min. Negotiated Rate	$82.14
Max. Negotiated Rate	$82.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.14
Rate for Payer: Hamaspik Choice Inc Medicare	$82.14

ZZ FLEXCHFLO870

Facility OP

$164.29

Service Code	HCPCS C1725
Hospital Charge Code	41569814
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$172.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.36
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	$82.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$94.47
Rate for Payer: Fidelis Medicare Advantage	$172.50
Rate for Payer: Group Health Inc Commercial	$82.14
Rate for Payer: Group Health Inc Medicare	$57.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.14
Rate for Payer: Hamaspik Choice Inc Medicare	$82.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.79

ZZ FLEXII FEM DL LUM KIT

Facility IP

$204.83

Service Code	HCPCS C1725
Hospital Charge Code	41567179
Hospital Revenue Code	278
Min. Negotiated Rate	$102.42
Max. Negotiated Rate	$102.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.42
Rate for Payer: Hamaspik Choice Inc Medicare	$102.42

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