St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZIM POROUS PLASMA SM

Facility

$11,955.00

Service Code	HCPCS C1713
Hospital Charge Code	40008337
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$12,552.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,575.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$7,173.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,977.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,874.12
Rate for Payer: EmblemHealth Commercial	$5,977.50
Rate for Payer: Fidelis Medicare Advantage	$12,552.75
Rate for Payer: Group Health Inc Commercial	$5,977.50
Rate for Payer: Group Health Inc Medicare	$4,184.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,977.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,977.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,770.75

ZIMR TRIBAL BEAT 20MM

Facility

$3,300.00

Service Code	HCPCS C1776
Hospital Charge Code	40008335
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,465.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,815.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,980.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,897.50
Rate for Payer: EmblemHealth Commercial	$1,650.00
Rate for Payer: Fidelis Medicare Advantage	$3,465.00
Rate for Payer: Group Health Inc Commercial	$1,650.00
Rate for Payer: Group Health Inc Medicare	$1,155.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,650.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,145.00

ZIMR TRIBAL BEAT 20MM

Facility

$3,300.00

Service Code	HCPCS C1776
Hospital Charge Code	40008335
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$1,650.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,650.00

ZIM SEG ANCHOR PLUG

Facility

$3,225.00

Service Code	HCPCS C1713
Hospital Charge Code	40008339
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,386.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,773.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,935.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,612.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,854.38
Rate for Payer: EmblemHealth Commercial	$1,612.50
Rate for Payer: Fidelis Medicare Advantage	$3,386.25
Rate for Payer: Group Health Inc Commercial	$1,612.50
Rate for Payer: Group Health Inc Medicare	$1,128.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,612.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,612.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,096.25

ZIM SEG ANCHOR PLUG

Facility

$3,225.00

Service Code	HCPCS C1713
Hospital Charge Code	40008339
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$1,612.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,612.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,612.50

ZIM SHELL 56 MM OD SIZE KK

Facility

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40009261
Hospital Revenue Code	278
Min. Negotiated Rate	$1,900.00
Max. Negotiated Rate	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00

ZIM SHELL 56 MM OD SIZE KK

Facility

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40009261
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,990.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,090.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,280.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,185.00
Rate for Payer: EmblemHealth Commercial	$1,900.00
Rate for Payer: Fidelis Medicare Advantage	$3,990.00
Rate for Payer: Group Health Inc Commercial	$1,900.00
Rate for Payer: Group Health Inc Medicare	$1,330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,470.00

ZIM SIZ 4 TIB COMP 12MM HGT

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	40009267
Hospital Revenue Code	278
Min. Negotiated Rate	$3,884.00
Max. Negotiated Rate	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00

ZIM SIZ 4 TIB COMP 12MM HGT

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	40009267
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,156.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,272.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,660.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,884.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,466.60
Rate for Payer: EmblemHealth Commercial	$3,884.00
Rate for Payer: Fidelis Medicare Advantage	$8,156.40
Rate for Payer: Group Health Inc Commercial	$3,884.00
Rate for Payer: Group Health Inc Medicare	$2,718.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,049.20

ZIM STEM CEM HA 2 TAPER 12/14

Facility

$7,176.00

Service Code	HCPCS C1776
Hospital Charge Code	40004600
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,534.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,946.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,305.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,588.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,126.20
Rate for Payer: EmblemHealth Commercial	$3,588.00
Rate for Payer: Fidelis Medicare Advantage	$7,534.80
Rate for Payer: Group Health Inc Commercial	$3,588.00
Rate for Payer: Group Health Inc Medicare	$2,511.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,588.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,588.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,664.40

ZIM STEM CEM HA 2 TAPER 12/14

Facility

$7,176.00

Service Code	HCPCS C1776
Hospital Charge Code	40004600
Hospital Revenue Code	278
Min. Negotiated Rate	$3,588.00
Max. Negotiated Rate	$3,588.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,588.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,588.00

ZIM STEM HA 2 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40008321
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,802.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,134.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,601.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,668.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,368.20
Rate for Payer: EmblemHealth Commercial	$4,668.00
Rate for Payer: Fidelis Medicare Advantage	$9,802.80
Rate for Payer: Group Health Inc Commercial	$4,668.00
Rate for Payer: Group Health Inc Medicare	$3,267.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,068.40

ZIM STEM HA 2 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40008321
Hospital Revenue Code	278
Min. Negotiated Rate	$4,668.00
Max. Negotiated Rate	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00

ZIM STEM S HA 5 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40009262
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,802.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,134.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,601.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,668.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,368.20
Rate for Payer: EmblemHealth Commercial	$4,668.00
Rate for Payer: Fidelis Medicare Advantage	$9,802.80
Rate for Payer: Group Health Inc Commercial	$4,668.00
Rate for Payer: Group Health Inc Medicare	$3,267.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,068.40

ZIM STEM S HA 5 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40009262
Hospital Revenue Code	278
Min. Negotiated Rate	$4,668.00
Max. Negotiated Rate	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00

ZIM STEM STAND 4 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40204255
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,802.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,134.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,601.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,668.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,368.20
Rate for Payer: EmblemHealth Commercial	$4,668.00
Rate for Payer: Fidelis Medicare Advantage	$9,802.80
Rate for Payer: Group Health Inc Commercial	$4,668.00
Rate for Payer: Group Health Inc Medicare	$3,267.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,068.40

ZIM STEM STAND 4 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40204255
Hospital Revenue Code	278
Min. Negotiated Rate	$4,668.00
Max. Negotiated Rate	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00

ZIM STEM STAND UNCE 5 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40009279
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,802.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,134.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,601.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,668.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,368.20
Rate for Payer: EmblemHealth Commercial	$4,668.00
Rate for Payer: Fidelis Medicare Advantage	$9,802.80
Rate for Payer: Group Health Inc Commercial	$4,668.00
Rate for Payer: Group Health Inc Medicare	$3,267.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,068.40

ZIM STEM STAND UNCE 5 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40009279
Hospital Revenue Code	278
Min. Negotiated Rate	$4,668.00
Max. Negotiated Rate	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00

ZIM STEM UNCEM HA 5 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40204433
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,802.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,134.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,601.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,668.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,368.20
Rate for Payer: EmblemHealth Commercial	$4,668.00
Rate for Payer: Fidelis Medicare Advantage	$9,802.80
Rate for Payer: Group Health Inc Commercial	$4,668.00
Rate for Payer: Group Health Inc Medicare	$3,267.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,068.40

ZIM STEM UNCEM HA 5 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40204433
Hospital Revenue Code	278
Min. Negotiated Rate	$4,668.00
Max. Negotiated Rate	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00

ZIM STEM UNCEM HA 6 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40204432
Hospital Revenue Code	278
Min. Negotiated Rate	$4,668.00
Max. Negotiated Rate	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00

ZIM STEM UNCEM HA 6 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40204432
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,802.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,134.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,601.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,668.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,368.20
Rate for Payer: EmblemHealth Commercial	$4,668.00
Rate for Payer: Fidelis Medicare Advantage	$9,802.80
Rate for Payer: Group Health Inc Commercial	$4,668.00
Rate for Payer: Group Health Inc Medicare	$3,267.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,068.40

ZIM STEM UNCEM HA 8 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40204431
Hospital Revenue Code	278
Min. Negotiated Rate	$4,668.00
Max. Negotiated Rate	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00

ZIM STEM UNCEM HA 8 TAPER 12/14

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40204431
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,802.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,134.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,601.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,668.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,368.20
Rate for Payer: EmblemHealth Commercial	$4,668.00
Rate for Payer: Fidelis Medicare Advantage	$9,802.80
Rate for Payer: Group Health Inc Commercial	$4,668.00
Rate for Payer: Group Health Inc Medicare	$3,267.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,068.40

Know your out-of-pocket cost for care.

All Charges