St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ SMARTSTENT #N1060AB 80CM/10MM

Facility OP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569010
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
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	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMARTSTENT #N1060AB 80CM/10MM

Facility IP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569010
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMARTSTENT #N740AB 7MM/40MM

Facility IP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569006
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMARTSTENT #N740AB 7MM/40MM

Facility OP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569006
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
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	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMARTSTENT #N840AB 80MM/8MM

Facility IP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569008
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMARTSTENT #N840AB 80MM/8MM

Facility OP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569008
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
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	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMARTSTENT #N860AB 80CM/8MM/60

Facility IP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569009
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMARTSTENT #N860AB 80CM/8MM/60

Facility OP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569009
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
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	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMARTSTENT #N940AB 9MM/40MM

Facility IP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569007
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMARTSTENT #N940AB 9MM/40MM

Facility OP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569007
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
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	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMRT STNT N1040AB 80CM/10MM 40

Facility IP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569011
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMRT STNT N1040AB 80CM/10MM 40

Facility OP

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569011
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
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	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SNARE KIT 5M 4FR 102CM

Facility IP

$779.63

Service Code	HCPCS C1773
Hospital Charge Code	41569684
Hospital Revenue Code	278
Min. Negotiated Rate	$389.82
Max. Negotiated Rate	$389.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$389.82
Rate for Payer: Hamaspik Choice Inc Medicare	$389.82

ZZ SNARE KIT 5M 4FR 102CM

Facility OP

$779.63

Service Code	HCPCS C1773
Hospital Charge Code	41569684
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$818.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$428.80
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	$389.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$448.29
Rate for Payer: Fidelis Medicare Advantage	$818.61
Rate for Payer: Group Health Inc Commercial	$389.82
Rate for Payer: Group Health Inc Medicare	$272.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$389.82
Rate for Payer: Hamaspik Choice Inc Medicare	$389.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$506.76

ZZ SNARE KIT GN1000 10MM .038 120

Facility OP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569028
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$546.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.52
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	$260.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.54
Rate for Payer: Fidelis Medicare Advantage	$546.99
Rate for Payer: Group Health Inc Commercial	$260.47
Rate for Payer: Group Health Inc Medicare	$182.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$338.61

ZZ SNARE KIT GN1000 10MM .038 120

Facility IP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569028
Hospital Revenue Code	278
Min. Negotiated Rate	$260.47
Max. Negotiated Rate	$260.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47

ZZ SNARE KIT GN1500 15MM .052

Facility OP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569029
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$546.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.52
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	$260.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.54
Rate for Payer: Fidelis Medicare Advantage	$546.99
Rate for Payer: Group Health Inc Commercial	$260.47
Rate for Payer: Group Health Inc Medicare	$182.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$338.61

ZZ SNARE KIT GN1500 15MM .052

Facility IP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569029
Hospital Revenue Code	278
Min. Negotiated Rate	$260.47
Max. Negotiated Rate	$260.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47

ZZ SNARE KIT GN2500 25MM .052

Facility IP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569030
Hospital Revenue Code	278
Min. Negotiated Rate	$260.47
Max. Negotiated Rate	$260.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47

ZZ SNARE KIT GN2500 25MM .052

Facility OP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569030
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$546.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.52
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	$260.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.54
Rate for Payer: Fidelis Medicare Advantage	$546.99
Rate for Payer: Group Health Inc Commercial	$260.47
Rate for Payer: Group Health Inc Medicare	$182.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$338.61

ZZ SNARE KIT GN3500 35MM .052

Facility IP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569031
Hospital Revenue Code	278
Min. Negotiated Rate	$260.47
Max. Negotiated Rate	$260.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47

ZZ SNARE KIT GN3500 35MM .052

Facility OP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569031
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$546.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.52
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	$260.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.54
Rate for Payer: Fidelis Medicare Advantage	$546.99
Rate for Payer: Group Health Inc Commercial	$260.47
Rate for Payer: Group Health Inc Medicare	$182.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$338.61

ZZ SNARE KIT GN500 5MM .038 120CM

Facility IP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569027
Hospital Revenue Code	278
Min. Negotiated Rate	$260.47
Max. Negotiated Rate	$260.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47

ZZ SNARE KIT GN500 5MM .038 120CM

Facility OP

$520.94

Service Code	HCPCS C1773
Hospital Charge Code	41569027
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$546.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.52
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	$260.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.54
Rate for Payer: Fidelis Medicare Advantage	$546.99
Rate for Payer: Group Health Inc Commercial	$260.47
Rate for Payer: Group Health Inc Medicare	$182.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.47
Rate for Payer: Hamaspik Choice Inc Medicare	$260.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$338.61

ZZ SNARE/LOOP/018/300CM

Facility IP

$39.33

Service Code	HCPCS C1725
Hospital Charge Code	41569485
Hospital Revenue Code	278
Min. Negotiated Rate	$19.66
Max. Negotiated Rate	$19.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.66
Rate for Payer: Hamaspik Choice Inc Medicare	$19.66

Price Transparency.

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