St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ POSIS XPEEDIOR 135CM

Facility OP

$4,039.88

Service Code	HCPCS C1757
Hospital Charge Code	41569726
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$4,241.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,221.93
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	$2,019.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,322.93
Rate for Payer: Fidelis Medicare Advantage	$4,241.87
Rate for Payer: Group Health Inc Commercial	$2,019.94
Rate for Payer: Group Health Inc Medicare	$1,413.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,019.94
Rate for Payer: Hamaspik Choice Inc Medicare	$2,019.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,625.92

ZZ POSIS XPEEDIOR 140 CM

Facility OP

$3,472.88

Service Code	HCPCS C1757
Hospital Charge Code	41569733
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$3,646.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,910.08
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	$1,736.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,996.91
Rate for Payer: Fidelis Medicare Advantage	$3,646.52
Rate for Payer: Group Health Inc Commercial	$1,736.44
Rate for Payer: Group Health Inc Medicare	$1,215.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,736.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,736.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,257.37

ZZ POSIS XPEEDIOR 140 CM

Facility IP

$3,472.88

Service Code	HCPCS C1757
Hospital Charge Code	41569733
Hospital Revenue Code	278
Min. Negotiated Rate	$1,736.44
Max. Negotiated Rate	$1,736.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,736.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,736.44

ZZ POSIS XPEEDIOR 60CM

Facility OP

$1,204.88

Service Code	HCPCS C1757
Hospital Charge Code	41569562
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$1,265.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$662.68
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	$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 POSIS XPEEDIOR 60CM

Facility IP

$1,204.88

Service Code	HCPCS C1757
Hospital Charge Code	41569562
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 POWERPICC 5F SINGLUMEN

Facility IP

$262.50

Service Code	HCPCS C1887
Hospital Charge Code	41567894
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

ZZ POWERPICC 5F SINGLUMEN

Facility OP

$262.50

Service Code	HCPCS C1887
Hospital Charge Code	41567894
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

ZZ POWERPICC 6F DUALLUMEN

Facility OP

$294.00

Service Code	HCPCS C1887
Hospital Charge Code	41569871
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$308.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$161.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$147.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$169.05
Rate for Payer: Fidelis Medicare Advantage	$308.70
Rate for Payer: Group Health Inc Commercial	$147.00
Rate for Payer: Group Health Inc Medicare	$102.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$147.00
Rate for Payer: Hamaspik Choice Inc Medicare	$147.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$191.10

ZZ POWERPICC 6F DUALLUMEN

Facility IP

$294.00

Service Code	HCPCS C1887
Hospital Charge Code	41569871
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$147.00
Rate for Payer: Hamaspik Choice Inc Medicare	$147.00

ZZ PROGLIDE 6F PERCLOSE

Facility OP

$590.00

Hospital Charge Code	41561923
Hospital Revenue Code	270
Min. Negotiated Rate	$206.50
Max. Negotiated Rate	$472.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$324.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$295.00
Rate for Payer: Aetna Government	$295.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$472.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$401.20
Rate for Payer: Group Health Inc Commercial	$295.00
Rate for Payer: Group Health Inc Medicare	$206.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$295.00

ZZ PROGREAT 2.8FR X 130CM

Facility OP

$1,080.00

Service Code	HCPCS C1887
Hospital Charge Code	41561918
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$1,134.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$594.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$540.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$621.00
Rate for Payer: Fidelis Medicare Advantage	$1,134.00
Rate for Payer: Group Health Inc Commercial	$540.00
Rate for Payer: Group Health Inc Medicare	$378.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$540.00
Rate for Payer: Hamaspik Choice Inc Medicare	$540.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$702.00

ZZ PROGREAT 2.8FR X 130CM

Facility IP

$1,080.00

Service Code	HCPCS C1887
Hospital Charge Code	41561918
Hospital Revenue Code	278
Min. Negotiated Rate	$540.00
Max. Negotiated Rate	$540.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$540.00
Rate for Payer: Hamaspik Choice Inc Medicare	$540.00

ZZ PROGREAT. MIC. CATH. SYST.

Facility IP

$660.00

Service Code	HCPCS C1887
Hospital Charge Code	41569960
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00

ZZ PROGREAT. MIC. CATH. SYST.

Facility OP

$660.00

Service Code	HCPCS C1887
Hospital Charge Code	41569960
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$693.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$363.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$330.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$379.50
Rate for Payer: Fidelis Medicare Advantage	$693.00
Rate for Payer: Group Health Inc Commercial	$330.00
Rate for Payer: Group Health Inc Medicare	$231.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$429.00

ZZ PROHANCE 15ML

Facility OP

$1,197.79

Hospital Charge Code	41567532
Hospital Revenue Code	270
Min. Negotiated Rate	$419.23
Max. Negotiated Rate	$958.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$658.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$598.90
Rate for Payer: Aetna Government	$598.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$958.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$814.50
Rate for Payer: Group Health Inc Commercial	$598.90
Rate for Payer: Group Health Inc Medicare	$419.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$598.90
Rate for Payer: Hamaspik Choice Inc Medicare	$598.90

ZZ PROHANCE 20ML

Facility OP

$1,481.29

Hospital Charge Code	41567533
Hospital Revenue Code	270
Min. Negotiated Rate	$518.45
Max. Negotiated Rate	$1,185.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$814.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$740.64
Rate for Payer: Aetna Government	$740.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,185.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,007.28
Rate for Payer: Group Health Inc Commercial	$740.64
Rate for Payer: Group Health Inc Medicare	$518.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$740.64
Rate for Payer: Hamaspik Choice Inc Medicare	$740.64

ZZ PROTECT STAT W/CONTRAS

Facility OP

$57.06

Hospital Charge Code	41567310
Hospital Revenue Code	270
Min. Negotiated Rate	$19.97
Max. Negotiated Rate	$45.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.53
Rate for Payer: Aetna Government	$28.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.80
Rate for Payer: Group Health Inc Commercial	$28.53
Rate for Payer: Group Health Inc Medicare	$19.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.53
Rate for Payer: Hamaspik Choice Inc Medicare	$28.53

ZZ PULM CATH 5/38/100/10S

Facility OP

$58.47

Service Code	HCPCS C1725
Hospital Charge Code	41567258
Hospital Revenue Code	278
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$61.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.16
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	$29.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.62
Rate for Payer: Fidelis Medicare Advantage	$61.39
Rate for Payer: Group Health Inc Commercial	$29.24
Rate for Payer: Group Health Inc Medicare	$20.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.24
Rate for Payer: Hamaspik Choice Inc Medicare	$29.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$38.01

ZZ PULM CATH 5/38/100/10S

Facility IP

$58.47

Service Code	HCPCS C1725
Hospital Charge Code	41567258
Hospital Revenue Code	278
Min. Negotiated Rate	$29.24
Max. Negotiated Rate	$29.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.24
Rate for Payer: Hamaspik Choice Inc Medicare	$29.24

ZZ PULMONARY LUMAX GUID CAT SET

Facility OP

$249.38

Hospital Charge Code	41569884
Hospital Revenue Code	270
Min. Negotiated Rate	$87.28
Max. Negotiated Rate	$199.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$137.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$124.69
Rate for Payer: Aetna Government	$124.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$199.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$169.58
Rate for Payer: Group Health Inc Commercial	$124.69
Rate for Payer: Group Health Inc Medicare	$87.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$124.69
Rate for Payer: Hamaspik Choice Inc Medicare	$124.69

ZZ PULSED INFUS SYS CATH

Facility OP

$652.05

Hospital Charge Code	41567171
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 PVA500-700 CONTOUR/MEDITECH

Facility OP

$403.99

Hospital Charge Code	41569471
Hospital Revenue Code	270
Min. Negotiated Rate	$141.40
Max. Negotiated Rate	$323.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$222.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$202.00
Rate for Payer: Aetna Government	$202.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$323.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$274.71
Rate for Payer: Group Health Inc Commercial	$202.00
Rate for Payer: Group Health Inc Medicare	$141.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$202.00
Rate for Payer: Hamaspik Choice Inc Medicare	$202.00

ZZ RENEGADE HIFLO MICROCATH135/20

Facility IP

$864.68

Service Code	HCPCS C1887
Hospital Charge Code	41569749
Hospital Revenue Code	278
Min. Negotiated Rate	$432.34
Max. Negotiated Rate	$432.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$432.34
Rate for Payer: Hamaspik Choice Inc Medicare	$432.34

ZZ RENEGADE HIFLO MICROCATH135/20

Facility OP

$864.68

Service Code	HCPCS C1887
Hospital Charge Code	41569749
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$907.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$475.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$432.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$497.19
Rate for Payer: Fidelis Medicare Advantage	$907.91
Rate for Payer: Group Health Inc Commercial	$432.34
Rate for Payer: Group Health Inc Medicare	$302.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$432.34
Rate for Payer: Hamaspik Choice Inc Medicare	$432.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$562.04

ZZ RENO 60 100ML

Facility OP

$121.57

Hospital Charge Code	41567535
Hospital Revenue Code	270
Min. Negotiated Rate	$42.55
Max. Negotiated Rate	$97.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.78
Rate for Payer: Aetna Government	$60.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.67
Rate for Payer: Group Health Inc Commercial	$60.78
Rate for Payer: Group Health Inc Medicare	$42.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.78
Rate for Payer: Hamaspik Choice Inc Medicare	$60.78

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