St. Barnabas Hospital

All Charges

Charge

Type

Price

ZZ WIRES 10/42 7F 75 110

Facility OP

$3,504.77

Hospital Charge Code	41567353
Hospital Revenue Code	270
Min. Negotiated Rate	$1,226.67
Max. Negotiated Rate	$2,803.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,927.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,752.38
Rate for Payer: Aetna Government	$1,752.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,803.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,383.24
Rate for Payer: Group Health Inc Commercial	$1,752.38
Rate for Payer: Group Health Inc Medicare	$1,226.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,752.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1,752.38

ZZ WIRES 10/68 7F 135 160

Facility OP

$3,896.00

Hospital Charge Code	41567356
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

ZZ WIRES 10/68 7F 75 110

Facility OP

$3,504.77

Hospital Charge Code	41567354
Hospital Revenue Code	270
Min. Negotiated Rate	$1,226.67
Max. Negotiated Rate	$2,803.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,927.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,752.38
Rate for Payer: Aetna Government	$1,752.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,803.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,383.24
Rate for Payer: Group Health Inc Commercial	$1,752.38
Rate for Payer: Group Health Inc Medicare	$1,226.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,752.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1,752.38

ZZ WIRES 10/94 7F 75 110

Facility OP

$5,623.94

Hospital Charge Code	41567357
Hospital Revenue Code	270
Min. Negotiated Rate	$1,968.38
Max. Negotiated Rate	$4,499.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,093.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,811.97
Rate for Payer: Aetna Government	$2,811.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,499.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,824.28
Rate for Payer: Group Health Inc Commercial	$2,811.97
Rate for Payer: Group Health Inc Medicare	$1,968.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,811.97
Rate for Payer: Hamaspik Choice Inc Medicare	$2,811.97

ZZ WIRES 12/60 7F 75 110

Facility OP

$3,504.77

Hospital Charge Code	41567358
Hospital Revenue Code	270
Min. Negotiated Rate	$1,226.67
Max. Negotiated Rate	$2,803.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,927.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,752.38
Rate for Payer: Aetna Government	$1,752.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,803.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,383.24
Rate for Payer: Group Health Inc Commercial	$1,752.38
Rate for Payer: Group Health Inc Medicare	$1,226.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,752.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1,752.38

ZZ WIRES 12/90 7F 75 110

Facility OP

$5,623.94

Hospital Charge Code	41567359
Hospital Revenue Code	270
Min. Negotiated Rate	$1,968.38
Max. Negotiated Rate	$4,499.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,093.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,811.97
Rate for Payer: Aetna Government	$2,811.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,499.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,824.28
Rate for Payer: Group Health Inc Commercial	$2,811.97
Rate for Payer: Group Health Inc Medicare	$1,968.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,811.97
Rate for Payer: Hamaspik Choice Inc Medicare	$2,811.97

ZZ WIRE TAD II 035-145

Facility OP

$255.15

Service Code	HCPCS C1725
Hospital Charge Code	41569675
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$267.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$140.33
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	$127.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$146.71
Rate for Payer: Fidelis Medicare Advantage	$267.91
Rate for Payer: Group Health Inc Commercial	$127.58
Rate for Payer: Group Health Inc Medicare	$89.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$127.58
Rate for Payer: Hamaspik Choice Inc Medicare	$127.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$165.85

ZZ WIRE TAD II 035-145

Facility IP

$255.15

Service Code	HCPCS C1725
Hospital Charge Code	41569675
Hospital Revenue Code	278
Min. Negotiated Rate	$127.58
Max. Negotiated Rate	$127.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$127.58
Rate for Payer: Hamaspik Choice Inc Medicare	$127.58

ZZ WIRE/TIP DEFLECTING/10CM

Facility OP

$77.35

Hospital Charge Code	41569186
Hospital Revenue Code	270
Min. Negotiated Rate	$27.07
Max. Negotiated Rate	$61.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$42.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$38.68
Rate for Payer: Aetna Government	$38.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$61.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$52.60
Rate for Payer: Group Health Inc Commercial	$38.68
Rate for Payer: Group Health Inc Medicare	$27.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.68
Rate for Payer: Hamaspik Choice Inc Medicare	$38.68

ZZ WIRE/TIP DEFLECTING/5CM

Facility OP

$90.91

Hospital Charge Code	41569187
Hospital Revenue Code	270
Min. Negotiated Rate	$31.82
Max. Negotiated Rate	$72.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$50.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.46
Rate for Payer: Aetna Government	$45.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.82
Rate for Payer: Group Health Inc Commercial	$45.46
Rate for Payer: Group Health Inc Medicare	$31.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.46
Rate for Payer: Hamaspik Choice Inc Medicare	$45.46

ZZ XCELA DUAL PICC 5F

Facility OP

$390.00

Hospital Charge Code	41561938
Hospital Revenue Code	270
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$312.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$195.00
Rate for Payer: Aetna Government	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$265.20
Rate for Payer: Group Health Inc Commercial	$195.00
Rate for Payer: Group Health Inc Medicare	$136.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

ZZ XCELA POWER PORT 6.6F

Facility OP

$680.00

Hospital Charge Code	41561934
Hospital Revenue Code	270
Min. Negotiated Rate	$238.00
Max. Negotiated Rate	$544.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$374.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$340.00
Rate for Payer: Aetna Government	$340.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$544.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$462.40
Rate for Payer: Group Health Inc Commercial	$340.00
Rate for Payer: Group Health Inc Medicare	$238.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$340.00
Rate for Payer: Hamaspik Choice Inc Medicare	$340.00

ZZ XCELA POWER PORT 8F

Facility OP

$680.00

Hospital Charge Code	41561935
Hospital Revenue Code	270
Min. Negotiated Rate	$238.00
Max. Negotiated Rate	$544.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$374.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$340.00
Rate for Payer: Aetna Government	$340.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$544.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$462.40
Rate for Payer: Group Health Inc Commercial	$340.00
Rate for Payer: Group Health Inc Medicare	$238.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$340.00
Rate for Payer: Hamaspik Choice Inc Medicare	$340.00

ZZ XCELA POWER PORT 9.6F

Facility OP

$1,600.00

Hospital Charge Code	41561936
Hospital Revenue Code	270
Min. Negotiated Rate	$560.00
Max. Negotiated Rate	$1,280.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$880.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$800.00
Rate for Payer: Aetna Government	$800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,280.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,088.00
Rate for Payer: Group Health Inc Commercial	$800.00
Rate for Payer: Group Health Inc Medicare	$560.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$800.00
Rate for Payer: Hamaspik Choice Inc Medicare	$800.00

ZZ XCELA SINGLE PICC 5F

Facility OP

$210.00

Hospital Charge Code	41561937
Hospital Revenue Code	270
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.00
Rate for Payer: Aetna Government	$105.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.80
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00

ZZ XPEEDIOR 135 CM

Facility OP

$2,847.05

Service Code	HCPCS C1769
Hospital Charge Code	41569774
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$2,989.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,565.88
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	$1,423.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,637.05
Rate for Payer: Fidelis Medicare Advantage	$2,989.40
Rate for Payer: Group Health Inc Commercial	$1,423.52
Rate for Payer: Group Health Inc Medicare	$996.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,423.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1,423.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,850.58

ZZ XPEEDIOR 135 CM

Facility IP

$2,847.05

Service Code	HCPCS C1769
Hospital Charge Code	41569774
Hospital Revenue Code	278
Min. Negotiated Rate	$1,423.52
Max. Negotiated Rate	$1,423.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,423.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1,423.52

ZZ XPEEDIOR 140 CM

Facility OP

$2,841.38

Service Code	HCPCS C1769
Hospital Charge Code	41569775
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$2,983.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,562.76
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	$1,420.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,633.79
Rate for Payer: Fidelis Medicare Advantage	$2,983.45
Rate for Payer: Group Health Inc Commercial	$1,420.69
Rate for Payer: Group Health Inc Medicare	$994.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,420.69
Rate for Payer: Hamaspik Choice Inc Medicare	$1,420.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,846.90

ZZ XPEEDIOR 140 CM

Facility IP

$2,841.38

Service Code	HCPCS C1769
Hospital Charge Code	41569775
Hospital Revenue Code	278
Min. Negotiated Rate	$1,420.69
Max. Negotiated Rate	$1,420.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,420.69
Rate for Payer: Hamaspik Choice Inc Medicare	$1,420.69

ZZ XXL BALOON 14-4/5.8/75

Facility IP

$961.78

Service Code	HCPCS C1725
Hospital Charge Code	41567276
Hospital Revenue Code	278
Min. Negotiated Rate	$480.89
Max. Negotiated Rate	$480.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$480.89
Rate for Payer: Hamaspik Choice Inc Medicare	$480.89

ZZ XXL BALOON 14-4/5.8/75

Facility OP

$961.78

Service Code	HCPCS C1725
Hospital Charge Code	41567276
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$1,009.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$528.98
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	$480.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$553.02
Rate for Payer: Fidelis Medicare Advantage	$1,009.87
Rate for Payer: Group Health Inc Commercial	$480.89
Rate for Payer: Group Health Inc Medicare	$336.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$480.89
Rate for Payer: Hamaspik Choice Inc Medicare	$480.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$625.16

ZZ XXL BALOON 16-4/5.8/75

Facility IP

$1,059.59

Service Code	HCPCS C1725
Hospital Charge Code	41567277
Hospital Revenue Code	278
Min. Negotiated Rate	$529.80
Max. Negotiated Rate	$529.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$529.80
Rate for Payer: Hamaspik Choice Inc Medicare	$529.80

ZZ XXL BALOON 16-4/5.8/75

Facility OP

$1,059.59

Service Code	HCPCS C1725
Hospital Charge Code	41567277
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$1,112.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$582.77
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	$529.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$609.26
Rate for Payer: Fidelis Medicare Advantage	$1,112.57
Rate for Payer: Group Health Inc Commercial	$529.80
Rate for Payer: Group Health Inc Medicare	$370.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$529.80
Rate for Payer: Hamaspik Choice Inc Medicare	$529.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$688.73

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