St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ THRUWAY GUIDEWIRE 018-190CM

Facility OP

$200.66

Service Code	HCPCS C1769
Hospital Charge Code	41569870
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$210.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.36
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	$100.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.38
Rate for Payer: Fidelis Medicare Advantage	$210.69
Rate for Payer: Group Health Inc Commercial	$100.33
Rate for Payer: Group Health Inc Medicare	$70.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.33
Rate for Payer: Hamaspik Choice Inc Medicare	$100.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$130.43

ZZ TLA NEEDLE SHEATH 19G/20CM

Facility OP

$67.34

Hospital Charge Code	41569722
Hospital Revenue Code	270
Min. Negotiated Rate	$23.57
Max. Negotiated Rate	$53.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.67
Rate for Payer: Aetna Government	$33.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.79
Rate for Payer: Group Health Inc Commercial	$33.67
Rate for Payer: Group Health Inc Medicare	$23.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.67
Rate for Payer: Hamaspik Choice Inc Medicare	$33.67

ZZ TNT GUID CATH 7/40/CL1

Facility OP

$277.13

Hospital Charge Code	41567215
Hospital Revenue Code	272
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$221.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$138.56
Rate for Payer: Aetna Government	$138.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$221.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.45
Rate for Payer: Group Health Inc Commercial	$138.56
Rate for Payer: Group Health Inc Medicare	$97.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.56
Rate for Payer: Hamaspik Choice Inc Medicare	$138.56

ZZ TNT GUID CATH 8/40/CL1

Facility OP

$277.13

Hospital Charge Code	41567216
Hospital Revenue Code	272
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$221.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$138.56
Rate for Payer: Aetna Government	$138.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$221.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.45
Rate for Payer: Group Health Inc Commercial	$138.56
Rate for Payer: Group Health Inc Medicare	$97.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.56
Rate for Payer: Hamaspik Choice Inc Medicare	$138.56

ZZ TORCON ADVANTAGE CATHETER

Facility IP

$37.00

Service Code	HCPCS C1725
Hospital Charge Code	41567743
Hospital Revenue Code	278
Min. Negotiated Rate	$18.50
Max. Negotiated Rate	$18.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.50
Rate for Payer: Hamaspik Choice Inc Medicare	$18.50

ZZ TORCON ADVANTAGE CATHETER

Facility OP

$37.00

Service Code	HCPCS C1725
Hospital Charge Code	41567743
Hospital Revenue Code	278
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.35
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	$18.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.28
Rate for Payer: Fidelis Medicare Advantage	$38.85
Rate for Payer: Group Health Inc Commercial	$18.50
Rate for Payer: Group Health Inc Medicare	$12.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.50
Rate for Payer: Hamaspik Choice Inc Medicare	$18.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$24.05

ZZ TORCON ADVANTAGE CATHETER

Facility OP

$55.10

Service Code	HCPCS C1725
Hospital Charge Code	41567738
Hospital Revenue Code	278
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$57.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.30
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	$27.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.68
Rate for Payer: Fidelis Medicare Advantage	$57.86
Rate for Payer: Group Health Inc Commercial	$27.55
Rate for Payer: Group Health Inc Medicare	$19.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.55
Rate for Payer: Hamaspik Choice Inc Medicare	$27.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.82

ZZ TORCON ADVANTAGE CATHETER

Facility IP

$55.10

Service Code	HCPCS C1725
Hospital Charge Code	41567738
Hospital Revenue Code	278
Min. Negotiated Rate	$27.55
Max. Negotiated Rate	$27.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.55
Rate for Payer: Hamaspik Choice Inc Medicare	$27.55

ZZ TORQUE DEVICE

Facility OP

$13.93

Hospital Charge Code	41569200
Hospital Revenue Code	270
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.96
Rate for Payer: Aetna Government	$6.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.47
Rate for Payer: Group Health Inc Commercial	$6.96
Rate for Payer: Group Health Inc Medicare	$4.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.96
Rate for Payer: Hamaspik Choice Inc Medicare	$6.96

ZZ TRACKER/TURBOTRACKER

Facility OP

$627.25

Service Code	HCPCS C1887
Hospital Charge Code	41569201
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$658.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$344.99
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	$313.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.67
Rate for Payer: Fidelis Medicare Advantage	$658.61
Rate for Payer: Group Health Inc Commercial	$313.62
Rate for Payer: Group Health Inc Medicare	$219.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.62
Rate for Payer: Hamaspik Choice Inc Medicare	$313.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$407.71

ZZ TRACKER/TURBOTRACKER

Facility IP

$627.25

Service Code	HCPCS C1887
Hospital Charge Code	41569201
Hospital Revenue Code	278
Min. Negotiated Rate	$313.62
Max. Negotiated Rate	$313.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.62
Rate for Payer: Hamaspik Choice Inc Medicare	$313.62

ZZ TRAIN SELECTIVE 4FR

Facility OP

$26.00

Hospital Charge Code	41561805
Hospital Revenue Code	270
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$20.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.00
Rate for Payer: Aetna Government	$13.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.68
Rate for Payer: Group Health Inc Commercial	$13.00
Rate for Payer: Group Health Inc Medicare	$9.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.00
Rate for Payer: Hamaspik Choice Inc Medicare	$13.00

ZZ TRANSDUCER STERILE COVER

Facility OP

$16.31

Hospital Charge Code	41567312
Hospital Revenue Code	270
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$13.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.16
Rate for Payer: Aetna Government	$8.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.09
Rate for Payer: Group Health Inc Commercial	$8.16
Rate for Payer: Group Health Inc Medicare	$5.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.16
Rate for Payer: Hamaspik Choice Inc Medicare	$8.16

ZZ TRANSJUGLAR LA SET RUPS 100L

Facility OP

$536.25

Hospital Charge Code	41569202
Hospital Revenue Code	270
Min. Negotiated Rate	$187.69
Max. Negotiated Rate	$429.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$294.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$268.12
Rate for Payer: Aetna Government	$268.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$429.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$364.65
Rate for Payer: Group Health Inc Commercial	$268.12
Rate for Payer: Group Health Inc Medicare	$187.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$268.12
Rate for Payer: Hamaspik Choice Inc Medicare	$268.12

ZZ TRANSJUG LIVER ACC SET

Facility OP

$847.67

Hospital Charge Code	41567324
Hospital Revenue Code	270
Min. Negotiated Rate	$296.68
Max. Negotiated Rate	$678.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$466.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$423.84
Rate for Payer: Aetna Government	$423.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$678.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$576.42
Rate for Payer: Group Health Inc Commercial	$423.84
Rate for Payer: Group Health Inc Medicare	$296.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.84
Rate for Payer: Hamaspik Choice Inc Medicare	$423.84

ZZ TRANSJUG LVR ACC TIPPS

Facility OP

$741.71

Hospital Charge Code	41567321
Hospital Revenue Code	270
Min. Negotiated Rate	$259.60
Max. Negotiated Rate	$593.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$407.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$370.86
Rate for Payer: Aetna Government	$370.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$593.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$504.36
Rate for Payer: Group Health Inc Commercial	$370.86
Rate for Payer: Group Health Inc Medicare	$259.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$370.86
Rate for Payer: Hamaspik Choice Inc Medicare	$370.86

ZZ TRANSJUNGLAR LA SET RUPS 100S

Facility OP

$663.39

Hospital Charge Code	41569203
Hospital Revenue Code	270
Min. Negotiated Rate	$232.19
Max. Negotiated Rate	$530.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$364.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$331.70
Rate for Payer: Aetna Government	$331.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$530.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$451.11
Rate for Payer: Group Health Inc Commercial	$331.70
Rate for Payer: Group Health Inc Medicare	$232.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$331.70
Rate for Payer: Hamaspik Choice Inc Medicare	$331.70

ZZ TRAY/C.V.I.R

Facility OP

$242.72

Hospital Charge Code	41569205
Hospital Revenue Code	270
Min. Negotiated Rate	$84.95
Max. Negotiated Rate	$194.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$121.36
Rate for Payer: Aetna Government	$121.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$194.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$165.05
Rate for Payer: Group Health Inc Commercial	$121.36
Rate for Payer: Group Health Inc Medicare	$84.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.36
Rate for Payer: Hamaspik Choice Inc Medicare	$121.36

ZZ TRAY,LUMBAR PUNCTURE,20X3.5

Facility OP

$47.63

Hospital Charge Code	41568093
Hospital Revenue Code	270
Min. Negotiated Rate	$16.67
Max. Negotiated Rate	$38.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.82
Rate for Payer: Aetna Government	$23.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.39
Rate for Payer: Group Health Inc Commercial	$23.82
Rate for Payer: Group Health Inc Medicare	$16.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.82
Rate for Payer: Hamaspik Choice Inc Medicare	$23.82

ZZ TRNSHP BIL STENT 6F/5/18

Facility OP

$3,472.88

Service Code	HCPCS C1876
Hospital Charge Code	41569769
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,646.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,910.08
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	$1,736.44
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 TRNSHP BIL STENT 6F/5/18

Facility IP

$3,472.88

Service Code	HCPCS C1876
Hospital Charge Code	41569769
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 TRNSHP BIL STENT 6F/6/18

Facility IP

$3,472.88

Service Code	HCPCS C1876
Hospital Charge Code	41569768
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 TRNSHP BIL STENT 6F/6/18

Facility OP

$3,472.88

Service Code	HCPCS C1876
Hospital Charge Code	41569768
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,646.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,910.08
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	$1,736.44
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 TRUWAVE 30CC/24IN

Facility OP

$90.00

Hospital Charge Code	41566950
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

ZZ TURNER PIGTAIL PIX SET

Facility OP

$117.30

Hospital Charge Code	41567322
Hospital Revenue Code	270
Min. Negotiated Rate	$41.06
Max. Negotiated Rate	$93.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$64.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$58.65
Rate for Payer: Aetna Government	$58.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$93.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$79.76
Rate for Payer: Group Health Inc Commercial	$58.65
Rate for Payer: Group Health Inc Medicare	$41.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.65
Rate for Payer: Hamaspik Choice Inc Medicare	$58.65

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