St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ SENORX VACUUM PACKAGE

Facility OP

$510.00

Hospital Charge Code	41568876
Hospital Revenue Code	279
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$408.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$280.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$255.00
Rate for Payer: Aetna Government	$255.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$408.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$346.80
Rate for Payer: Group Health Inc Commercial	$255.00
Rate for Payer: Group Health Inc Medicare	$178.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$255.00
Rate for Payer: Hamaspik Choice Inc Medicare	$255.00

ZZ SFT TIP GDCATH REN LNG

Facility OP

$374.93

Hospital Charge Code	41567284
Hospital Revenue Code	270
Min. Negotiated Rate	$131.23
Max. Negotiated Rate	$299.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$187.46
Rate for Payer: Aetna Government	$187.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$299.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$254.95
Rate for Payer: Group Health Inc Commercial	$187.46
Rate for Payer: Group Health Inc Medicare	$131.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.46
Rate for Payer: Hamaspik Choice Inc Medicare	$187.46

ZZ SFT TIP GDCATH REN SHO

Facility OP

$374.93

Hospital Charge Code	41567285
Hospital Revenue Code	270
Min. Negotiated Rate	$131.23
Max. Negotiated Rate	$299.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$187.46
Rate for Payer: Aetna Government	$187.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$299.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$254.95
Rate for Payer: Group Health Inc Commercial	$187.46
Rate for Payer: Group Health Inc Medicare	$131.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.46
Rate for Payer: Hamaspik Choice Inc Medicare	$187.46

ZZ SFT TIP GUID CTH-HOCKE

Facility OP

$374.93

Hospital Charge Code	41567283
Hospital Revenue Code	270
Min. Negotiated Rate	$131.23
Max. Negotiated Rate	$299.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$187.46
Rate for Payer: Aetna Government	$187.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$299.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$254.95
Rate for Payer: Group Health Inc Commercial	$187.46
Rate for Payer: Group Health Inc Medicare	$131.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.46
Rate for Payer: Hamaspik Choice Inc Medicare	$187.46

ZZ SHEATH 5 FR

Facility OP

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567506
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$56.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.77
Rate for Payer: Fidelis Medicare Advantage	$56.19
Rate for Payer: Group Health Inc Commercial	$26.76
Rate for Payer: Group Health Inc Medicare	$18.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.78

ZZ SHEATH 5 FR

Facility IP

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567506
Hospital Revenue Code	278
Min. Negotiated Rate	$26.76
Max. Negotiated Rate	$26.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76

ZZ SHEATH 5 FR.

Facility IP

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567515
Hospital Revenue Code	278
Min. Negotiated Rate	$26.76
Max. Negotiated Rate	$26.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76

ZZ SHEATH 5 FR.

Facility OP

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567515
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$56.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.77
Rate for Payer: Fidelis Medicare Advantage	$56.19
Rate for Payer: Group Health Inc Commercial	$26.76
Rate for Payer: Group Health Inc Medicare	$18.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.78

ZZ SHEATH 5FR. 10CM.

Facility IP

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567503
Hospital Revenue Code	278
Min. Negotiated Rate	$26.76
Max. Negotiated Rate	$26.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76

ZZ SHEATH 5FR. 10CM.

Facility OP

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567503
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$56.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.77
Rate for Payer: Fidelis Medicare Advantage	$56.19
Rate for Payer: Group Health Inc Commercial	$26.76
Rate for Payer: Group Health Inc Medicare	$18.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.78

ZZ SHEATH 5FR CATH 15-622

Facility IP

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567517
Hospital Revenue Code	278
Min. Negotiated Rate	$26.76
Max. Negotiated Rate	$26.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76

ZZ SHEATH 5FR CATH 15-622

Facility OP

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567517
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$56.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.77
Rate for Payer: Fidelis Medicare Advantage	$56.19
Rate for Payer: Group Health Inc Commercial	$26.76
Rate for Payer: Group Health Inc Medicare	$18.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.78

ZZ SHEATH 7 25 38

Facility OP

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567062
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$113.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.94
Rate for Payer: Fidelis Medicare Advantage	$113.12
Rate for Payer: Group Health Inc Commercial	$53.86
Rate for Payer: Group Health Inc Medicare	$37.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.02

ZZ SHEATH 7 25 38

Facility IP

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567062
Hospital Revenue Code	278
Min. Negotiated Rate	$53.86
Max. Negotiated Rate	$53.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86

ZZ SHEATH 8 25 38

Facility IP

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567063
Hospital Revenue Code	278
Min. Negotiated Rate	$53.86
Max. Negotiated Rate	$53.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86

ZZ SHEATH 8 25 38

Facility OP

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567063
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$113.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.94
Rate for Payer: Fidelis Medicare Advantage	$113.12
Rate for Payer: Group Health Inc Commercial	$53.86
Rate for Payer: Group Health Inc Medicare	$37.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.02

ZZ SHEATH/8F PINNACLE

Facility OP

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569474
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$413.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$196.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.18
Rate for Payer: Fidelis Medicare Advantage	$413.03
Rate for Payer: Group Health Inc Commercial	$196.68
Rate for Payer: Group Health Inc Medicare	$137.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$255.68

ZZ SHEATH/8F PINNACLE

Facility IP

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569474
Hospital Revenue Code	278
Min. Negotiated Rate	$196.68
Max. Negotiated Rate	$196.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68

ZZ SHEATH 9 25 38

Facility OP

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567064
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$113.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.94
Rate for Payer: Fidelis Medicare Advantage	$113.12
Rate for Payer: Group Health Inc Commercial	$53.86
Rate for Payer: Group Health Inc Medicare	$37.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.02

ZZ SHEATH 9 25 38

Facility IP

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567064
Hospital Revenue Code	278
Min. Negotiated Rate	$53.86
Max. Negotiated Rate	$53.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86

ZZ SHEATH/BALKIN/6F/30CM/RB

Facility OP

$111.37

Service Code	HCPCS C1892
Hospital Charge Code	41569475
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$116.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.04
Rate for Payer: Fidelis Medicare Advantage	$116.94
Rate for Payer: Group Health Inc Commercial	$55.68
Rate for Payer: Group Health Inc Medicare	$38.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.68
Rate for Payer: Hamaspik Choice Inc Medicare	$55.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72.39

ZZ SHEATH/BALKIN/6F/30CM/RB

Facility IP

$111.37

Service Code	HCPCS C1892
Hospital Charge Code	41569475
Hospital Revenue Code	278
Min. Negotiated Rate	$55.68
Max. Negotiated Rate	$55.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.68
Rate for Payer: Hamaspik Choice Inc Medicare	$55.68

ZZ SHEATH/BALKIN/7F/40CM/RB

Facility OP

$111.37

Service Code	HCPCS C1892
Hospital Charge Code	41569476
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$116.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.04
Rate for Payer: Fidelis Medicare Advantage	$116.94
Rate for Payer: Group Health Inc Commercial	$55.68
Rate for Payer: Group Health Inc Medicare	$38.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.68
Rate for Payer: Hamaspik Choice Inc Medicare	$55.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72.39

ZZ SHEATH/BALKIN/7F/40CM/RB

Facility IP

$111.37

Service Code	HCPCS C1892
Hospital Charge Code	41569476
Hospital Revenue Code	278
Min. Negotiated Rate	$55.68
Max. Negotiated Rate	$55.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.68
Rate for Payer: Hamaspik Choice Inc Medicare	$55.68

ZZ SHEATH/CHECK-FLO/9F

Facility OP

$94.88

Service Code	HCPCS C1892
Hospital Charge Code	41569477
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$99.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$52.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$54.56
Rate for Payer: Fidelis Medicare Advantage	$99.62
Rate for Payer: Group Health Inc Commercial	$47.44
Rate for Payer: Group Health Inc Medicare	$33.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.44
Rate for Payer: Hamaspik Choice Inc Medicare	$47.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$61.67

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