St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ KIT NEEDLE MISSION 18GX

Facility OP

$123.61

Hospital Charge Code	41568094
Hospital Revenue Code	270
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$98.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$61.80
Rate for Payer: Aetna Government	$61.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$98.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.05
Rate for Payer: Group Health Inc Commercial	$61.80
Rate for Payer: Group Health Inc Medicare	$43.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.80
Rate for Payer: Hamaspik Choice Inc Medicare	$61.80

ZZ KIT NEEDLE MISSION 20GX

Facility OP

$126.12

Hospital Charge Code	41568095
Hospital Revenue Code	270
Min. Negotiated Rate	$44.14
Max. Negotiated Rate	$100.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.06
Rate for Payer: Aetna Government	$63.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.76
Rate for Payer: Group Health Inc Commercial	$63.06
Rate for Payer: Group Health Inc Medicare	$44.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.06
Rate for Payer: Hamaspik Choice Inc Medicare	$63.06

ZZ LATEX PROBE COVER

Facility OP

$6.38

Hospital Charge Code	41567291
Hospital Revenue Code	270
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$5.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.19
Rate for Payer: Aetna Government	$3.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.34
Rate for Payer: Group Health Inc Commercial	$3.19
Rate for Payer: Group Health Inc Medicare	$2.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.19
Rate for Payer: Hamaspik Choice Inc Medicare	$3.19

ZZ LEVEEN COACC ELEC 3.0/15/15

Facility OP

$1,950.00

Hospital Charge Code	41568517
Hospital Revenue Code	270
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$1,560.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,072.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$975.00
Rate for Payer: Aetna Government	$975.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,560.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,326.00
Rate for Payer: Group Health Inc Commercial	$975.00
Rate for Payer: Group Health Inc Medicare	$682.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$975.00
Rate for Payer: Hamaspik Choice Inc Medicare	$975.00

ZZ LEVEEN COACC ELEC 3.5/15/15

Facility OP

$2,300.00

Hospital Charge Code	41568518
Hospital Revenue Code	270
Min. Negotiated Rate	$805.00
Max. Negotiated Rate	$1,840.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,265.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,150.00
Rate for Payer: Aetna Government	$1,150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,840.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,564.00
Rate for Payer: Group Health Inc Commercial	$1,150.00
Rate for Payer: Group Health Inc Medicare	$805.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,150.00

ZZ LEVEEN COACC ELEC 4.0/15/15

Facility OP

$2,700.00

Hospital Charge Code	41568519
Hospital Revenue Code	270
Min. Negotiated Rate	$945.00
Max. Negotiated Rate	$2,160.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,350.00
Rate for Payer: Aetna Government	$1,350.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,836.00
Rate for Payer: Group Health Inc Commercial	$1,350.00
Rate for Payer: Group Health Inc Medicare	$945.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,350.00

ZZ LEVEEN COACC INT SET

Facility OP

$140.00

Hospital Charge Code	41568520
Hospital Revenue Code	270
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$112.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.00
Rate for Payer: Aetna Government	$70.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.20
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00

ZZ LEVEEN NDL ELEC 2.0/15/12

Facility OP

$1,550.00

Hospital Charge Code	41568530
Hospital Revenue Code	270
Min. Negotiated Rate	$542.50
Max. Negotiated Rate	$1,240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$852.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$775.00
Rate for Payer: Aetna Government	$775.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,054.00
Rate for Payer: Group Health Inc Commercial	$775.00
Rate for Payer: Group Health Inc Medicare	$542.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$775.00
Rate for Payer: Hamaspik Choice Inc Medicare	$775.00

ZZ LEVEEN NDL ELEC 2.0/15/15

Facility OP

$1,550.00

Hospital Charge Code	41568531
Hospital Revenue Code	270
Min. Negotiated Rate	$542.50
Max. Negotiated Rate	$1,240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$852.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$775.00
Rate for Payer: Aetna Government	$775.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,054.00
Rate for Payer: Group Health Inc Commercial	$775.00
Rate for Payer: Group Health Inc Medicare	$542.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$775.00
Rate for Payer: Hamaspik Choice Inc Medicare	$775.00

ZZ LEVEEN NDL ELEC 2.0/17/15

Facility OP

$1,750.00

Hospital Charge Code	41568513
Hospital Revenue Code	270
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.00
Rate for Payer: Aetna Government	$875.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.00
Rate for Payer: Group Health Inc Commercial	$875.00
Rate for Payer: Group Health Inc Medicare	$612.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$875.00

ZZ LEVEEN NDL ELEC 2.0/17/25

Facility OP

$1,750.00

Hospital Charge Code	41568514
Hospital Revenue Code	270
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.00
Rate for Payer: Aetna Government	$875.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.00
Rate for Payer: Group Health Inc Commercial	$875.00
Rate for Payer: Group Health Inc Medicare	$612.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$875.00

ZZ LEVEEN NDL ELEC 3.0/15/12

Facility OP

$1,750.00

Hospital Charge Code	41568528
Hospital Revenue Code	270
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.00
Rate for Payer: Aetna Government	$875.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.00
Rate for Payer: Group Health Inc Commercial	$875.00
Rate for Payer: Group Health Inc Medicare	$612.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$875.00

ZZ LEVEEN NDL ELEC 3.0/15/15

Facility OP

$1,750.00

Hospital Charge Code	41568529
Hospital Revenue Code	270
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.00
Rate for Payer: Aetna Government	$875.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.00
Rate for Payer: Group Health Inc Commercial	$875.00
Rate for Payer: Group Health Inc Medicare	$612.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$875.00

ZZ LEVEEN NDL ELEC 3.0/17/15

Facility OP

$2,000.00

Hospital Charge Code	41568515
Hospital Revenue Code	270
Min. Negotiated Rate	$700.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,000.00
Rate for Payer: Aetna Government	$1,000.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,360.00
Rate for Payer: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

ZZ LEVEEN NDL ELEC 3.0/17/25

Facility OP

$2,000.00

Hospital Charge Code	41568516
Hospital Revenue Code	270
Min. Negotiated Rate	$700.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,000.00
Rate for Payer: Aetna Government	$1,000.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,360.00
Rate for Payer: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

ZZ LEVEEN NDL ELEC 3.5/15/12

Facility OP

$2,100.00

Hospital Charge Code	41568525
Hospital Revenue Code	270
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$1,680.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,155.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,050.00
Rate for Payer: Aetna Government	$1,050.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,680.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,428.00
Rate for Payer: Group Health Inc Commercial	$1,050.00
Rate for Payer: Group Health Inc Medicare	$735.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,050.00

ZZ LEVEEN NDL ELEC 3.5/15/15

Facility OP

$2,100.00

Hospital Charge Code	41568526
Hospital Revenue Code	270
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$1,680.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,155.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,050.00
Rate for Payer: Aetna Government	$1,050.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,680.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,428.00
Rate for Payer: Group Health Inc Commercial	$1,050.00
Rate for Payer: Group Health Inc Medicare	$735.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,050.00

ZZ LEVEEN NDL ELEC 3.5/15/25

Facility OP

$2,100.00

Hospital Charge Code	41568527
Hospital Revenue Code	270
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$1,680.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,155.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,050.00
Rate for Payer: Aetna Government	$1,050.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,680.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,428.00
Rate for Payer: Group Health Inc Commercial	$1,050.00
Rate for Payer: Group Health Inc Medicare	$735.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,050.00

ZZ LEVEEN NDL ELEC 4.0/14/15

Facility OP

$2,400.00

Hospital Charge Code	41568523
Hospital Revenue Code	270
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,920.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,200.00
Rate for Payer: Aetna Government	$1,200.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,920.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,632.00
Rate for Payer: Group Health Inc Commercial	$1,200.00
Rate for Payer: Group Health Inc Medicare	$840.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.00

ZZ LEVEEN NDL ELEC 4.0/14/25

Facility OP

$2,400.00

Hospital Charge Code	41568524
Hospital Revenue Code	270
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,920.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,200.00
Rate for Payer: Aetna Government	$1,200.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,920.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,632.00
Rate for Payer: Group Health Inc Commercial	$1,200.00
Rate for Payer: Group Health Inc Medicare	$840.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.00

ZZ LEVEEN NDL ELEC 5.0/13/15

Facility OP

$3,000.00

Hospital Charge Code	41568521
Hospital Revenue Code	270
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,500.00
Rate for Payer: Aetna Government	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,040.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

ZZ LEVEEN NDL ELEC 5.0/13/25

Facility OP

$3,000.00

Hospital Charge Code	41568522
Hospital Revenue Code	270
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,500.00
Rate for Payer: Aetna Government	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,040.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

ZZ LIVER ACC BIOPSY SET

Facility OP

$968.15

Hospital Charge Code	41567323
Hospital Revenue Code	270
Min. Negotiated Rate	$338.85
Max. Negotiated Rate	$774.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$532.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$484.08
Rate for Payer: Aetna Government	$484.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$774.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$658.34
Rate for Payer: Group Health Inc Commercial	$484.08
Rate for Payer: Group Health Inc Medicare	$338.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$484.08
Rate for Payer: Hamaspik Choice Inc Medicare	$484.08

ZZ LIVER ACCESS/BIOPSY SET

Facility OP

$639.37

Hospital Charge Code	41569254
Hospital Revenue Code	270
Min. Negotiated Rate	$223.78
Max. Negotiated Rate	$511.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$351.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$319.68
Rate for Payer: Aetna Government	$319.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$511.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$434.77
Rate for Payer: Group Health Inc Commercial	$319.68
Rate for Payer: Group Health Inc Medicare	$223.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$319.68
Rate for Payer: Hamaspik Choice Inc Medicare	$319.68

ZZ LOCM 300-399MG/ML IODINE 1ML

Facility OP

$32.60

Service Code	HCPCS Q9967
Hospital Charge Code	41569595
Hospital Revenue Code	255
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$26.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.11
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
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.13
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.14
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.15
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.15
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.19

Price Transparency.

All Charges