St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ MEDI CATH HK 1.0 5X65

Facility OP

$50.89

Hospital Charge Code	41569628
Hospital Revenue Code	270
Min. Negotiated Rate	$17.81
Max. Negotiated Rate	$40.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.44
Rate for Payer: Aetna Government	$25.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.61
Rate for Payer: Group Health Inc Commercial	$25.44
Rate for Payer: Group Health Inc Medicare	$17.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.44
Rate for Payer: Hamaspik Choice Inc Medicare	$25.44

ZZ MEDI CATH RENE 130/20

Facility OP

$836.33

Hospital Charge Code	41569576
Hospital Revenue Code	270
Min. Negotiated Rate	$292.72
Max. Negotiated Rate	$669.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$459.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$418.16
Rate for Payer: Aetna Government	$418.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$669.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$568.70
Rate for Payer: Group Health Inc Commercial	$418.16
Rate for Payer: Group Health Inc Medicare	$292.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$418.16
Rate for Payer: Hamaspik Choice Inc Medicare	$418.16

ZZ MEDI CATH RENE 150/10

Facility OP

$836.33

Hospital Charge Code	41569577
Hospital Revenue Code	270
Min. Negotiated Rate	$292.72
Max. Negotiated Rate	$669.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$459.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$418.16
Rate for Payer: Aetna Government	$418.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$669.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$568.70
Rate for Payer: Group Health Inc Commercial	$418.16
Rate for Payer: Group Health Inc Medicare	$292.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$418.16
Rate for Payer: Hamaspik Choice Inc Medicare	$418.16

ZZ MEDI CATH RENE 150/20

Facility OP

$836.33

Hospital Charge Code	41569578
Hospital Revenue Code	270
Min. Negotiated Rate	$292.72
Max. Negotiated Rate	$669.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$459.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$418.16
Rate for Payer: Aetna Government	$418.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$669.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$568.70
Rate for Payer: Group Health Inc Commercial	$418.16
Rate for Payer: Group Health Inc Medicare	$292.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$418.16
Rate for Payer: Hamaspik Choice Inc Medicare	$418.16

ZZ MEDI SP CATHETER

Facility OP

$1,037.61

Hospital Charge Code	41569581
Hospital Revenue Code	270
Min. Negotiated Rate	$363.16
Max. Negotiated Rate	$830.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$570.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$518.80
Rate for Payer: Aetna Government	$518.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$830.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$705.57
Rate for Payer: Group Health Inc Commercial	$518.80
Rate for Payer: Group Health Inc Medicare	$363.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$518.80
Rate for Payer: Hamaspik Choice Inc Medicare	$518.80

ZZ MEDITECH FLO SWITCH P

Facility OP

$12.26

Hospital Charge Code	41569604
Hospital Revenue Code	270
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$9.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.13
Rate for Payer: Aetna Government	$6.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.34
Rate for Payer: Group Health Inc Commercial	$6.13
Rate for Payer: Group Health Inc Medicare	$4.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.13
Rate for Payer: Hamaspik Choice Inc Medicare	$6.13

ZZ MEDITECH GLIDEWR

Facility OP

$419.86

Hospital Charge Code	41569603
Hospital Revenue Code	270
Min. Negotiated Rate	$146.95
Max. Negotiated Rate	$335.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$209.93
Rate for Payer: Aetna Government	$209.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$285.50
Rate for Payer: Group Health Inc Commercial	$209.93
Rate for Payer: Group Health Inc Medicare	$146.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.93
Rate for Payer: Hamaspik Choice Inc Medicare	$209.93

ZZ MEDITECH GLIDEWR SS

Facility OP

$652.05

Hospital Charge Code	41569602
Hospital Revenue Code	270
Min. Negotiated Rate	$228.22
Max. Negotiated Rate	$521.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$358.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$326.02
Rate for Payer: Aetna Government	$326.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$521.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$443.39
Rate for Payer: Group Health Inc Commercial	$326.02
Rate for Payer: Group Health Inc Medicare	$228.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$326.02
Rate for Payer: Hamaspik Choice Inc Medicare	$326.02

ZZ MEDITECH OASIS THROMB. CATH

Facility OP

$1,641.47

Service Code	HCPCS C1757
Hospital Charge Code	41569547
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$1,723.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$902.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.33
Rate for Payer: Aetna Government	$16.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$820.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$943.85
Rate for Payer: Fidelis Medicare Advantage	$1,723.54
Rate for Payer: Group Health Inc Commercial	$820.74
Rate for Payer: Group Health Inc Medicare	$574.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$820.74
Rate for Payer: Hamaspik Choice Inc Medicare	$820.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,066.96

ZZ MEDITECH OASIS THROMB. CATH

Facility IP

$1,641.47

Service Code	HCPCS C1757
Hospital Charge Code	41569547
Hospital Revenue Code	278
Min. Negotiated Rate	$820.74
Max. Negotiated Rate	$820.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$820.74
Rate for Payer: Hamaspik Choice Inc Medicare	$820.74

ZZ MEDITECH OASIS THROMB. KIT

Facility OP

$82.22

Service Code	HCPCS C1757
Hospital Charge Code	41569531
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$86.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.33
Rate for Payer: Aetna Government	$16.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.28
Rate for Payer: Fidelis Medicare Advantage	$86.33
Rate for Payer: Group Health Inc Commercial	$41.11
Rate for Payer: Group Health Inc Medicare	$28.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.11
Rate for Payer: Hamaspik Choice Inc Medicare	$41.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$53.44

ZZ MEDITECH OASIS THROMB. KIT

Facility IP

$82.22

Service Code	HCPCS C1757
Hospital Charge Code	41569531
Hospital Revenue Code	278
Min. Negotiated Rate	$41.11
Max. Negotiated Rate	$41.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.11
Rate for Payer: Hamaspik Choice Inc Medicare	$41.11

ZZ MEDITECH RENEGADE 130/20/1 TIP

Facility IP

$836.33

Service Code	HCPCS C1769
Hospital Charge Code	41569542
Hospital Revenue Code	278
Min. Negotiated Rate	$418.16
Max. Negotiated Rate	$418.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$418.16
Rate for Payer: Hamaspik Choice Inc Medicare	$418.16

ZZ MEDITECH RENEGADE 130/20/1 TIP

Facility OP

$836.33

Service Code	HCPCS C1769
Hospital Charge Code	41569542
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$878.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$459.98
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	$418.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$480.89
Rate for Payer: Fidelis Medicare Advantage	$878.15
Rate for Payer: Group Health Inc Commercial	$418.16
Rate for Payer: Group Health Inc Medicare	$292.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$418.16
Rate for Payer: Hamaspik Choice Inc Medicare	$418.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$543.61

ZZ MEDITECH TRANSEND .018 GUIDWR

Facility OP

$467.78

Service Code	HCPCS C1769
Hospital Charge Code	41569541
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$491.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$257.28
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	$233.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$268.97
Rate for Payer: Fidelis Medicare Advantage	$491.17
Rate for Payer: Group Health Inc Commercial	$233.89
Rate for Payer: Group Health Inc Medicare	$163.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.89
Rate for Payer: Hamaspik Choice Inc Medicare	$233.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$304.06

ZZ MEDITECH TRANSEND .018 GUIDWR

Facility IP

$467.78

Service Code	HCPCS C1769
Hospital Charge Code	41569541
Hospital Revenue Code	278
Min. Negotiated Rate	$233.89
Max. Negotiated Rate	$233.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.89
Rate for Payer: Hamaspik Choice Inc Medicare	$233.89

ZZ MEDITECH WALLGRAFT 70/507

Facility IP

$6,378.75

Service Code	HCPCS C1876
Hospital Charge Code	41569546
Hospital Revenue Code	278
Min. Negotiated Rate	$3,189.38
Max. Negotiated Rate	$3,189.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,189.38
Rate for Payer: Hamaspik Choice Inc Medicare	$3,189.38

ZZ MEDITECH WALLGRAFT 70/507

Facility OP

$6,378.75

Service Code	HCPCS C1876
Hospital Charge Code	41569546
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$6,697.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,508.31
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	$3,189.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,667.78
Rate for Payer: Fidelis Medicare Advantage	$6,697.69
Rate for Payer: Group Health Inc Commercial	$3,189.38
Rate for Payer: Group Health Inc Medicare	$2,232.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,189.38
Rate for Payer: Hamaspik Choice Inc Medicare	$3,189.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,146.19

ZZ MEDITECH WALLGRAFT 70/575

Facility IP

$5,528.25

Service Code	HCPCS C1876
Hospital Charge Code	41569544
Hospital Revenue Code	278
Min. Negotiated Rate	$2,764.12
Max. Negotiated Rate	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,764.12

ZZ MEDITECH WALLGRAFT 70/575

Facility OP

$5,528.25

Service Code	HCPCS C1876
Hospital Charge Code	41569544
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$5,804.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,040.54
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	$2,764.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,178.74
Rate for Payer: Fidelis Medicare Advantage	$5,804.66
Rate for Payer: Group Health Inc Commercial	$2,764.12
Rate for Payer: Group Health Inc Medicare	$1,934.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,764.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,593.36

ZZ MEDITECH WALLGRAFT 70/585

Facility OP

$5,528.25

Service Code	HCPCS C1876
Hospital Charge Code	41569545
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$5,804.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,040.54
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	$2,764.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,178.74
Rate for Payer: Fidelis Medicare Advantage	$5,804.66
Rate for Payer: Group Health Inc Commercial	$2,764.12
Rate for Payer: Group Health Inc Medicare	$1,934.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,764.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,593.36

ZZ MEDITECH WALLGRAFT 70/585

Facility IP

$5,528.25

Service Code	HCPCS C1876
Hospital Charge Code	41569545
Hospital Revenue Code	278
Min. Negotiated Rate	$2,764.12
Max. Negotiated Rate	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,764.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,764.12

ZZ MEDI WIRE KATZEN 35/145

Facility OP

$510.30

Hospital Charge Code	41569582
Hospital Revenue Code	270
Min. Negotiated Rate	$178.60
Max. Negotiated Rate	$408.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$280.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$255.15
Rate for Payer: Aetna Government	$255.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$408.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$347.00
Rate for Payer: Group Health Inc Commercial	$255.15
Rate for Payer: Group Health Inc Medicare	$178.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$255.15
Rate for Payer: Hamaspik Choice Inc Medicare	$255.15

ZZ MEDI WIRE TRNSEND 18

Facility OP

$467.78

Hospital Charge Code	41569579
Hospital Revenue Code	270
Min. Negotiated Rate	$163.72
Max. Negotiated Rate	$374.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$257.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$233.89
Rate for Payer: Aetna Government	$233.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$374.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$318.09
Rate for Payer: Group Health Inc Commercial	$233.89
Rate for Payer: Group Health Inc Medicare	$163.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.89
Rate for Payer: Hamaspik Choice Inc Medicare	$233.89

ZZ MEDI WIRE V-18 CONTRL

Facility OP

$269.33

Hospital Charge Code	41569580
Hospital Revenue Code	270
Min. Negotiated Rate	$94.27
Max. Negotiated Rate	$215.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.66
Rate for Payer: Aetna Government	$134.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$215.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.14
Rate for Payer: Group Health Inc Commercial	$134.66
Rate for Payer: Group Health Inc Medicare	$94.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$134.66
Rate for Payer: Hamaspik Choice Inc Medicare	$134.66

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