St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ WIRE/GLIDE/.035/150CM

Facility OP

$356.69

Service Code	HCPCS C1769
Hospital Charge Code	41569164
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$374.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$196.18
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	$178.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$205.10
Rate for Payer: Fidelis Medicare Advantage	$374.52
Rate for Payer: Group Health Inc Commercial	$178.34
Rate for Payer: Group Health Inc Medicare	$124.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.34
Rate for Payer: Hamaspik Choice Inc Medicare	$178.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$231.85

ZZ WIRE/GLIDE/.035/150CM

Facility IP

$356.69

Service Code	HCPCS C1769
Hospital Charge Code	41569164
Hospital Revenue Code	278
Min. Negotiated Rate	$178.34
Max. Negotiated Rate	$178.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.34
Rate for Payer: Hamaspik Choice Inc Medicare	$178.34

ZZ WIRE/GLIDE/.038/150CM

Facility OP

$356.69

Hospital Charge Code	41569165
Hospital Revenue Code	270
Min. Negotiated Rate	$124.84
Max. Negotiated Rate	$285.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$196.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$178.34
Rate for Payer: Aetna Government	$178.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$285.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$242.55
Rate for Payer: Group Health Inc Commercial	$178.34
Rate for Payer: Group Health Inc Medicare	$124.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.34
Rate for Payer: Hamaspik Choice Inc Medicare	$178.34

ZZ WIRE/GLIDE SS/.035/180CM

Facility OP

$569.31

Service Code	HCPCS C1769
Hospital Charge Code	41569159
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$597.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$313.12
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	$284.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$327.35
Rate for Payer: Fidelis Medicare Advantage	$597.78
Rate for Payer: Group Health Inc Commercial	$284.66
Rate for Payer: Group Health Inc Medicare	$199.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$284.66
Rate for Payer: Hamaspik Choice Inc Medicare	$284.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$370.05

ZZ WIRE/GLIDE SS/.035/180CM

Facility IP

$569.31

Service Code	HCPCS C1769
Hospital Charge Code	41569159
Hospital Revenue Code	278
Min. Negotiated Rate	$284.66
Max. Negotiated Rate	$284.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$284.66
Rate for Payer: Hamaspik Choice Inc Medicare	$284.66

ZZ WIRE/GLIDE SS/.038/150CM

Facility OP

$548.05

Service Code	HCPCS C1769
Hospital Charge Code	41569161
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$575.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$301.43
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	$274.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$315.13
Rate for Payer: Fidelis Medicare Advantage	$575.45
Rate for Payer: Group Health Inc Commercial	$274.02
Rate for Payer: Group Health Inc Medicare	$191.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.02
Rate for Payer: Hamaspik Choice Inc Medicare	$274.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$356.23

ZZ WIRE/GLIDE SS/.038/150CM

Facility IP

$548.05

Service Code	HCPCS C1769
Hospital Charge Code	41569161
Hospital Revenue Code	278
Min. Negotiated Rate	$274.02
Max. Negotiated Rate	$274.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.02
Rate for Payer: Hamaspik Choice Inc Medicare	$274.02

ZZ WIRE/GLIDE SS/.038/260CM

Facility OP

$601.21

Hospital Charge Code	41569160
Hospital Revenue Code	270
Min. Negotiated Rate	$210.42
Max. Negotiated Rate	$480.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$300.60
Rate for Payer: Aetna Government	$300.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$480.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$408.82
Rate for Payer: Group Health Inc Commercial	$300.60
Rate for Payer: Group Health Inc Medicare	$210.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.60
Rate for Payer: Hamaspik Choice Inc Medicare	$300.60

ZZ WIRE/GOLDGLIDE/.018/180CM/45

Facility OP

$372.10

Service Code	HCPCS C1769
Hospital Charge Code	41569166
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$390.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$204.66
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	$186.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$213.96
Rate for Payer: Fidelis Medicare Advantage	$390.70
Rate for Payer: Group Health Inc Commercial	$186.05
Rate for Payer: Group Health Inc Medicare	$130.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$186.05
Rate for Payer: Hamaspik Choice Inc Medicare	$186.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$241.86

ZZ WIRE/GOLDGLIDE/.018/180CM/45

Facility IP

$372.10

Service Code	HCPCS C1769
Hospital Charge Code	41569166
Hospital Revenue Code	278
Min. Negotiated Rate	$186.05
Max. Negotiated Rate	$186.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$186.05
Rate for Payer: Hamaspik Choice Inc Medicare	$186.05

ZZ WIRE/GOLDGLIDE/.018/180CM/70

Facility IP

$372.10

Service Code	HCPCS C1769
Hospital Charge Code	41569167
Hospital Revenue Code	278
Min. Negotiated Rate	$186.05
Max. Negotiated Rate	$186.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$186.05
Rate for Payer: Hamaspik Choice Inc Medicare	$186.05

ZZ WIRE/GOLDGLIDE/.018/180CM/70

Facility OP

$372.10

Service Code	HCPCS C1769
Hospital Charge Code	41569167
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$390.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$204.66
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	$186.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$213.96
Rate for Payer: Fidelis Medicare Advantage	$390.70
Rate for Payer: Group Health Inc Commercial	$186.05
Rate for Payer: Group Health Inc Medicare	$130.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$186.05
Rate for Payer: Hamaspik Choice Inc Medicare	$186.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$241.86

ZZ WIRE/MEASURING/.035/145CM

Facility OP

$10.83

Hospital Charge Code	41569172
Hospital Revenue Code	270
Min. Negotiated Rate	$3.79
Max. Negotiated Rate	$8.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.42
Rate for Payer: Aetna Government	$5.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.36
Rate for Payer: Group Health Inc Commercial	$5.42
Rate for Payer: Group Health Inc Medicare	$3.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.42
Rate for Payer: Hamaspik Choice Inc Medicare	$5.42

ZZ WIRE NEWTON LT 035-260CM

Facility OP

$60.95

Hospital Charge Code	41569672
Hospital Revenue Code	270
Min. Negotiated Rate	$21.33
Max. Negotiated Rate	$48.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.48
Rate for Payer: Aetna Government	$30.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$41.45
Rate for Payer: Group Health Inc Commercial	$30.48
Rate for Payer: Group Health Inc Medicare	$21.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.48
Rate for Payer: Hamaspik Choice Inc Medicare	$30.48

ZZ WIRE NITINOL 018-6CM

Facility OP

$7.00

Hospital Charge Code	41569673
Hospital Revenue Code	270
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50

ZZ WIRE PLAT + 018-180

Facility OP

$215.43

Hospital Charge Code	41569674
Hospital Revenue Code	270
Min. Negotiated Rate	$75.40
Max. Negotiated Rate	$172.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$118.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$107.72
Rate for Payer: Aetna Government	$107.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$172.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$146.49
Rate for Payer: Group Health Inc Commercial	$107.72
Rate for Payer: Group Health Inc Medicare	$75.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$107.72
Rate for Payer: Hamaspik Choice Inc Medicare	$107.72

ZZ WIRE/PLAT+/018/260CM

Facility OP

$222.19

Hospital Charge Code	41569177
Hospital Revenue Code	270
Min. Negotiated Rate	$77.77
Max. Negotiated Rate	$177.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$111.10
Rate for Payer: Aetna Government	$111.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$151.09
Rate for Payer: Group Health Inc Commercial	$111.10
Rate for Payer: Group Health Inc Medicare	$77.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.10
Rate for Payer: Hamaspik Choice Inc Medicare	$111.10

ZZ WIRE PLAT+/018/80CM

Facility OP

$183.92

Hospital Charge Code	41569212
Hospital Revenue Code	270
Min. Negotiated Rate	$64.37
Max. Negotiated Rate	$147.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$101.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$91.96
Rate for Payer: Aetna Government	$91.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$147.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$125.07
Rate for Payer: Group Health Inc Commercial	$91.96
Rate for Payer: Group Health Inc Medicare	$64.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.96
Rate for Payer: Hamaspik Choice Inc Medicare	$91.96

ZZ WIRE/PLAT+/025/180CM

Facility OP

$222.19

Service Code	HCPCS C1769
Hospital Charge Code	41569178
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$233.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.20
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	$111.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.76
Rate for Payer: Fidelis Medicare Advantage	$233.30
Rate for Payer: Group Health Inc Commercial	$111.10
Rate for Payer: Group Health Inc Medicare	$77.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.10
Rate for Payer: Hamaspik Choice Inc Medicare	$111.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.42

ZZ WIRE/PLAT+/025/180CM

Facility IP

$222.19

Service Code	HCPCS C1769
Hospital Charge Code	41569178
Hospital Revenue Code	278
Min. Negotiated Rate	$111.10
Max. Negotiated Rate	$111.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.10
Rate for Payer: Hamaspik Choice Inc Medicare	$111.10

ZZ WIRE/ROADRUNNER/.018/180CM

Facility OP

$201.10

Hospital Charge Code	41569179
Hospital Revenue Code	270
Min. Negotiated Rate	$70.38
Max. Negotiated Rate	$160.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.55
Rate for Payer: Aetna Government	$100.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.75
Rate for Payer: Group Health Inc Commercial	$100.55
Rate for Payer: Group Health Inc Medicare	$70.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.55
Rate for Payer: Hamaspik Choice Inc Medicare	$100.55

ZZ WIRE/ROADRUNNER/.035/180CM

Facility OP

$51.57

Hospital Charge Code	41569181
Hospital Revenue Code	270
Min. Negotiated Rate	$18.05
Max. Negotiated Rate	$41.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.78
Rate for Payer: Aetna Government	$25.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.07
Rate for Payer: Group Health Inc Commercial	$25.78
Rate for Payer: Group Health Inc Medicare	$18.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.78
Rate for Payer: Hamaspik Choice Inc Medicare	$25.78

ZZ WIRE/ROADRUNNER LT/.035/180CM

Facility OP

$57.75

Hospital Charge Code	41569180
Hospital Revenue Code	270
Min. Negotiated Rate	$20.21
Max. Negotiated Rate	$46.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.88
Rate for Payer: Aetna Government	$28.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.27
Rate for Payer: Group Health Inc Commercial	$28.88
Rate for Payer: Group Health Inc Medicare	$20.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.88
Rate for Payer: Hamaspik Choice Inc Medicare	$28.88

ZZ WIRE/ROSEN/.035/180CM

Facility OP

$27.86

Hospital Charge Code	41569182
Hospital Revenue Code	270
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$22.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.93
Rate for Payer: Aetna Government	$13.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.94
Rate for Payer: Group Health Inc Commercial	$13.93
Rate for Payer: Group Health Inc Medicare	$9.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.93
Rate for Payer: Hamaspik Choice Inc Medicare	$13.93

ZZ WIRES 10/42 7F 135 160

Facility OP

$3,896.00

Hospital Charge Code	41567355
Hospital Revenue Code	270
Min. Negotiated Rate	$1,363.60
Max. Negotiated Rate	$3,116.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,142.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,948.00
Rate for Payer: Aetna Government	$1,948.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,116.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,649.28
Rate for Payer: Group Health Inc Commercial	$1,948.00
Rate for Payer: Group Health Inc Medicare	$1,363.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,948.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,948.00

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