St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ LUMINEX STENT L7 X 40 6F

Facility IP

$4,394.25

Service Code	HCPCS C1876
Hospital Charge Code	41569757
Hospital Revenue Code	278
Min. Negotiated Rate	$2,197.12
Max. Negotiated Rate	$2,197.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,197.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,197.12

ZZ LUMINEX STENT L7 X 40 6F

Facility OP

$4,394.25

Service Code	HCPCS C1876
Hospital Charge Code	41569757
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,613.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,416.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,197.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,526.69
Rate for Payer: Fidelis Medicare Advantage	$4,613.96
Rate for Payer: Group Health Inc Commercial	$2,197.12
Rate for Payer: Group Health Inc Medicare	$1,537.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,197.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,197.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,856.26

ZZ MAGNEVIST 15ML

Facility OP

$84.44

Hospital Charge Code	41568411
Hospital Revenue Code	270
Min. Negotiated Rate	$29.55
Max. Negotiated Rate	$67.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$42.22
Rate for Payer: Aetna Government	$42.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$57.42
Rate for Payer: Group Health Inc Commercial	$42.22
Rate for Payer: Group Health Inc Medicare	$29.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.22
Rate for Payer: Hamaspik Choice Inc Medicare	$42.22

ZZ MAGNEVIST 20ML

Facility OP

$112.58

Hospital Charge Code	41568412
Hospital Revenue Code	270
Min. Negotiated Rate	$39.40
Max. Negotiated Rate	$90.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.29
Rate for Payer: Aetna Government	$56.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.55
Rate for Payer: Group Health Inc Commercial	$56.29
Rate for Payer: Group Health Inc Medicare	$39.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.29
Rate for Payer: Hamaspik Choice Inc Medicare	$56.29

ZZ MAHURKAR QPLUS 13.5FR X 16CM

Facility OP

$847.46

Service Code	HCPCS C1725
Hospital Charge Code	41569874
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$889.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$466.10
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	$423.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$487.29
Rate for Payer: Fidelis Medicare Advantage	$889.83
Rate for Payer: Group Health Inc Commercial	$423.73
Rate for Payer: Group Health Inc Medicare	$296.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.73
Rate for Payer: Hamaspik Choice Inc Medicare	$423.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$550.85

ZZ MAHURKAR QPLUS 13.5FR X 16CM

Facility IP

$847.46

Service Code	HCPCS C1725
Hospital Charge Code	41569874
Hospital Revenue Code	278
Min. Negotiated Rate	$423.73
Max. Negotiated Rate	$423.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.73
Rate for Payer: Hamaspik Choice Inc Medicare	$423.73

ZZ MAHURKAR QPLUS 13.5FR X 19.5CM

Facility OP

$847.46

Service Code	HCPCS C1725
Hospital Charge Code	41569875
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$889.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$466.10
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	$423.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$487.29
Rate for Payer: Fidelis Medicare Advantage	$889.83
Rate for Payer: Group Health Inc Commercial	$423.73
Rate for Payer: Group Health Inc Medicare	$296.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.73
Rate for Payer: Hamaspik Choice Inc Medicare	$423.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$550.85

ZZ MAHURKAR QPLUS 13.5FR X 19.5CM

Facility IP

$847.46

Service Code	HCPCS C1725
Hospital Charge Code	41569875
Hospital Revenue Code	278
Min. Negotiated Rate	$423.73
Max. Negotiated Rate	$423.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.73
Rate for Payer: Hamaspik Choice Inc Medicare	$423.73

ZZ MAHURKAR QPLUS 13.5FR X 24CM

Facility OP

$880.89

Service Code	HCPCS C1725
Hospital Charge Code	41569876
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$924.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$484.49
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	$440.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$506.51
Rate for Payer: Fidelis Medicare Advantage	$924.93
Rate for Payer: Group Health Inc Commercial	$440.44
Rate for Payer: Group Health Inc Medicare	$308.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$440.44
Rate for Payer: Hamaspik Choice Inc Medicare	$440.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$572.58

ZZ MAHURKAR QPLUS 13.5FR X 24CM

Facility IP

$880.89

Service Code	HCPCS C1725
Hospital Charge Code	41569876
Hospital Revenue Code	278
Min. Negotiated Rate	$440.44
Max. Negotiated Rate	$440.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$440.44
Rate for Payer: Hamaspik Choice Inc Medicare	$440.44

ZZ MAHURTR CATH 11.5 19.5

Facility OP

$234.60

Hospital Charge Code	41567280
Hospital Revenue Code	270
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$187.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$117.30
Rate for Payer: Aetna Government	$117.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$187.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.53
Rate for Payer: Group Health Inc Commercial	$117.30
Rate for Payer: Group Health Inc Medicare	$82.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.30
Rate for Payer: Hamaspik Choice Inc Medicare	$117.30

ZZ MAHURTR CATHKIT 11.5 13

Facility OP

$234.60

Hospital Charge Code	41567281
Hospital Revenue Code	270
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$187.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$117.30
Rate for Payer: Aetna Government	$117.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$187.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.53
Rate for Payer: Group Health Inc Commercial	$117.30
Rate for Payer: Group Health Inc Medicare	$82.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.30
Rate for Payer: Hamaspik Choice Inc Medicare	$117.30

ZZ MAHURTR CATHKIT 11.5 16

Facility OP

$234.60

Hospital Charge Code	41567282
Hospital Revenue Code	270
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$187.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$117.30
Rate for Payer: Aetna Government	$117.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$187.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.53
Rate for Payer: Group Health Inc Commercial	$117.30
Rate for Payer: Group Health Inc Medicare	$82.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.30
Rate for Payer: Hamaspik Choice Inc Medicare	$117.30

ZZ MALLINCKRODT TAD 2 WIRE

Facility OP

$255.15

Hospital Charge Code	41569631
Hospital Revenue Code	270
Min. Negotiated Rate	$89.30
Max. Negotiated Rate	$204.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$140.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$127.58
Rate for Payer: Aetna Government	$127.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.50
Rate for Payer: Group Health Inc Commercial	$127.58
Rate for Payer: Group Health Inc Medicare	$89.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$127.58
Rate for Payer: Hamaspik Choice Inc Medicare	$127.58

ZZ MANIFOLD/LEET

Facility OP

$41.46

Hospital Charge Code	41569255
Hospital Revenue Code	270
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$33.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.73
Rate for Payer: Aetna Government	$20.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.19
Rate for Payer: Group Health Inc Commercial	$20.73
Rate for Payer: Group Health Inc Medicare	$14.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.73
Rate for Payer: Hamaspik Choice Inc Medicare	$20.73

ZZ MANIFOLD PERC HIG PRE

Facility OP

$65.21

Hospital Charge Code	41567309
Hospital Revenue Code	270
Min. Negotiated Rate	$22.82
Max. Negotiated Rate	$52.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.60
Rate for Payer: Aetna Government	$32.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.34
Rate for Payer: Group Health Inc Commercial	$32.60
Rate for Payer: Group Health Inc Medicare	$22.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.60
Rate for Payer: Hamaspik Choice Inc Medicare	$32.60

ZZ MANIFOLD/RIGHT

Facility OP

$41.46

Hospital Charge Code	41569256
Hospital Revenue Code	270
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$33.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.73
Rate for Payer: Aetna Government	$20.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.19
Rate for Payer: Group Health Inc Commercial	$20.73
Rate for Payer: Group Health Inc Medicare	$14.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.73
Rate for Payer: Hamaspik Choice Inc Medicare	$20.73

ZZ MARK 7ARTERION-SYRINGE

Facility OP

$19.50

Hospital Charge Code	41566953
Hospital Revenue Code	272
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$15.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.75
Rate for Payer: Aetna Government	$9.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.26
Rate for Payer: Group Health Inc Commercial	$9.75
Rate for Payer: Group Health Inc Medicare	$6.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.75
Rate for Payer: Hamaspik Choice Inc Medicare	$9.75

ZZ MCRONEST 18-14-10

Facility OP

$237.44

Hospital Charge Code	41569787
Hospital Revenue Code	270
Min. Negotiated Rate	$83.10
Max. Negotiated Rate	$189.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.72
Rate for Payer: Aetna Government	$118.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$189.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.46
Rate for Payer: Group Health Inc Commercial	$118.72
Rate for Payer: Group Health Inc Medicare	$83.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.72
Rate for Payer: Hamaspik Choice Inc Medicare	$118.72

ZZ MCRONEST 18-14-3

Facility OP

$237.44

Hospital Charge Code	41569788
Hospital Revenue Code	270
Min. Negotiated Rate	$83.10
Max. Negotiated Rate	$189.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.72
Rate for Payer: Aetna Government	$118.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$189.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.46
Rate for Payer: Group Health Inc Commercial	$118.72
Rate for Payer: Group Health Inc Medicare	$83.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.72
Rate for Payer: Hamaspik Choice Inc Medicare	$118.72

ZZ MCRONEST 18-14-4

Facility OP

$237.44

Hospital Charge Code	41569789
Hospital Revenue Code	270
Min. Negotiated Rate	$83.10
Max. Negotiated Rate	$189.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.72
Rate for Payer: Aetna Government	$118.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$189.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.46
Rate for Payer: Group Health Inc Commercial	$118.72
Rate for Payer: Group Health Inc Medicare	$83.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.72
Rate for Payer: Hamaspik Choice Inc Medicare	$118.72

ZZ MCRONEST 18-14-6

Facility OP

$237.44

Hospital Charge Code	41569790
Hospital Revenue Code	270
Min. Negotiated Rate	$83.10
Max. Negotiated Rate	$189.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.72
Rate for Payer: Aetna Government	$118.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$189.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.46
Rate for Payer: Group Health Inc Commercial	$118.72
Rate for Payer: Group Health Inc Medicare	$83.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.72
Rate for Payer: Hamaspik Choice Inc Medicare	$118.72

ZZ MCRONEST 18-14-8

Facility OP

$237.44

Hospital Charge Code	41569791
Hospital Revenue Code	270
Min. Negotiated Rate	$83.10
Max. Negotiated Rate	$189.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.72
Rate for Payer: Aetna Government	$118.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$189.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.46
Rate for Payer: Group Health Inc Commercial	$118.72
Rate for Payer: Group Health Inc Medicare	$83.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.72
Rate for Payer: Hamaspik Choice Inc Medicare	$118.72

ZZ MEDALLION SERIES SYRINGE

Facility OP

$4.79

Hospital Charge Code	41569257
Hospital Revenue Code	270
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$3.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.40
Rate for Payer: Aetna Government	$2.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.26
Rate for Payer: Group Health Inc Commercial	$2.40
Rate for Payer: Group Health Inc Medicare	$1.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.40
Rate for Payer: Hamaspik Choice Inc Medicare	$2.40

ZZ MEDALLION SYRINGE #MSS011 LB

Facility OP

$18.96

Hospital Charge Code	41569015
Hospital Revenue Code	270
Min. Negotiated Rate	$6.64
Max. Negotiated Rate	$15.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.48
Rate for Payer: Aetna Government	$9.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.89
Rate for Payer: Group Health Inc Commercial	$9.48
Rate for Payer: Group Health Inc Medicare	$6.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.48
Rate for Payer: Hamaspik Choice Inc Medicare	$9.48

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