St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ AMPLATZ EX WR 38/S/260

Facility

$81.51

Service Code	HCPCS C1769
Hospital Charge Code	41567121
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$85.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$48.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.87
Rate for Payer: EmblemHealth Commercial	$40.76
Rate for Payer: Fidelis Medicare Advantage	$85.59
Rate for Payer: Group Health Inc Commercial	$40.76
Rate for Payer: Group Health Inc Medicare	$28.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.76
Rate for Payer: Hamaspik Choice Inc Medicare	$40.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.98

ZZ AMPLATZ GSNECK MCR KIT

Facility

$1,548.62

Service Code	HCPCS C1769
Hospital Charge Code	41567279
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$1,626.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$851.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$929.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$774.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$890.46
Rate for Payer: EmblemHealth Commercial	$774.31
Rate for Payer: Fidelis Medicare Advantage	$1,626.05
Rate for Payer: Group Health Inc Commercial	$774.31
Rate for Payer: Group Health Inc Medicare	$542.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$774.31
Rate for Payer: Hamaspik Choice Inc Medicare	$774.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,006.60

ZZ AMPLATZ GSNECK MCR KIT

Facility

$1,548.62

Service Code	HCPCS C1769
Hospital Charge Code	41567279
Hospital Revenue Code	278
Min. Negotiated Rate	$774.31
Max. Negotiated Rate	$774.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$774.31
Rate for Payer: Hamaspik Choice Inc Medicare	$774.31

ZZ AMPLATZ RETV DEV GSNEC

Facility

$635.75

Service Code	HCPCS C1769
Hospital Charge Code	41567278
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$667.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$349.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$381.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$317.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$365.56
Rate for Payer: EmblemHealth Commercial	$317.88
Rate for Payer: Fidelis Medicare Advantage	$667.54
Rate for Payer: Group Health Inc Commercial	$317.88
Rate for Payer: Group Health Inc Medicare	$222.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$317.88
Rate for Payer: Hamaspik Choice Inc Medicare	$317.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$413.24

ZZ AMPLATZ RETV DEV GSNEC

Facility

$635.75

Service Code	HCPCS C1769
Hospital Charge Code	41567278
Hospital Revenue Code	278
Min. Negotiated Rate	$317.88
Max. Negotiated Rate	$317.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$317.88
Rate for Payer: Hamaspik Choice Inc Medicare	$317.88

ZZ AMPLATZ SP STIF 35-145

Facility

$81.51

Service Code	HCPCS C1769
Hospital Charge Code	41567122
Hospital Revenue Code	278
Min. Negotiated Rate	$40.76
Max. Negotiated Rate	$40.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.76
Rate for Payer: Hamaspik Choice Inc Medicare	$40.76

ZZ AMPLATZ SP STIF 35-145

Facility

$81.51

Service Code	HCPCS C1769
Hospital Charge Code	41567122
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$85.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$48.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.87
Rate for Payer: EmblemHealth Commercial	$40.76
Rate for Payer: Fidelis Medicare Advantage	$85.59
Rate for Payer: Group Health Inc Commercial	$40.76
Rate for Payer: Group Health Inc Medicare	$28.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.76
Rate for Payer: Hamaspik Choice Inc Medicare	$40.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.98

ZZ AMPLATZ SP STIF 35-180

Facility

$133.60

Service Code	HCPCS C1769
Hospital Charge Code	41567123
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$140.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$73.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$80.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.82
Rate for Payer: EmblemHealth Commercial	$66.80
Rate for Payer: Fidelis Medicare Advantage	$140.28
Rate for Payer: Group Health Inc Commercial	$66.80
Rate for Payer: Group Health Inc Medicare	$46.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.80
Rate for Payer: Hamaspik Choice Inc Medicare	$66.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$86.84

ZZ AMPLATZ SP STIF 35-180

Facility

$133.60

Service Code	HCPCS C1769
Hospital Charge Code	41567123
Hospital Revenue Code	278
Min. Negotiated Rate	$66.80
Max. Negotiated Rate	$66.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.80
Rate for Payer: Hamaspik Choice Inc Medicare	$66.80

ZZ AMPLATZ SP STIF 35-260

Facility

$136.79

Service Code	HCPCS C1769
Hospital Charge Code	41567124
Hospital Revenue Code	278
Min. Negotiated Rate	$68.40
Max. Negotiated Rate	$68.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.40
Rate for Payer: Hamaspik Choice Inc Medicare	$68.40

ZZ AMPLATZ SP STIF 35-260

Facility

$136.79

Service Code	HCPCS C1769
Hospital Charge Code	41567124
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$143.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$75.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$82.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$68.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.65
Rate for Payer: EmblemHealth Commercial	$68.40
Rate for Payer: Fidelis Medicare Advantage	$143.63
Rate for Payer: Group Health Inc Commercial	$68.40
Rate for Payer: Group Health Inc Medicare	$47.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.40
Rate for Payer: Hamaspik Choice Inc Medicare	$68.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$88.91

ZZ AMPLATZ SP STIF 35-75

Facility

$84.69

Service Code	HCPCS C1769
Hospital Charge Code	41567126
Hospital Revenue Code	278
Min. Negotiated Rate	$42.34
Max. Negotiated Rate	$42.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.34
Rate for Payer: Hamaspik Choice Inc Medicare	$42.34

ZZ AMPLATZ SP STIF 35-75

Facility

$84.69

Service Code	HCPCS C1769
Hospital Charge Code	41567126
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$88.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$50.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.70
Rate for Payer: EmblemHealth Commercial	$42.34
Rate for Payer: Fidelis Medicare Advantage	$88.92
Rate for Payer: Group Health Inc Commercial	$42.34
Rate for Payer: Group Health Inc Medicare	$29.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.34
Rate for Payer: Hamaspik Choice Inc Medicare	$42.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$55.05

ZZ AMPLATZ SP STIF 35/755

Facility

$81.51

Service Code	HCPCS C1769
Hospital Charge Code	41567125
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$85.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$48.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.87
Rate for Payer: EmblemHealth Commercial	$40.76
Rate for Payer: Fidelis Medicare Advantage	$85.59
Rate for Payer: Group Health Inc Commercial	$40.76
Rate for Payer: Group Health Inc Medicare	$28.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.76
Rate for Payer: Hamaspik Choice Inc Medicare	$40.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.98

ZZ AMPLATZ SP STIF 35/755

Facility

$81.51

Service Code	HCPCS C1769
Hospital Charge Code	41567125
Hospital Revenue Code	278
Min. Negotiated Rate	$40.76
Max. Negotiated Rate	$40.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.76
Rate for Payer: Hamaspik Choice Inc Medicare	$40.76

ZZ AMPLT SS GDW 032/145

Facility

$70.88

Service Code	HCPCS C1769
Hospital Charge Code	41569776
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$74.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$42.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.76
Rate for Payer: EmblemHealth Commercial	$35.44
Rate for Payer: Fidelis Medicare Advantage	$74.42
Rate for Payer: Group Health Inc Commercial	$35.44
Rate for Payer: Group Health Inc Medicare	$24.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.44
Rate for Payer: Hamaspik Choice Inc Medicare	$35.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.07

ZZ AMPLT SS GDW 032/145

Facility

$70.88

Service Code	HCPCS C1769
Hospital Charge Code	41569776
Hospital Revenue Code	278
Min. Negotiated Rate	$35.44
Max. Negotiated Rate	$35.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.44
Rate for Payer: Hamaspik Choice Inc Medicare	$35.44

ZZ ANGIODYN 5F OMNFLUSH

Facility

$45.08

Service Code	HCPCS C1725
Hospital Charge Code	41569600
Hospital Revenue Code	278
Min. Negotiated Rate	$15.78
Max. Negotiated Rate	$47.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$27.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.92
Rate for Payer: EmblemHealth Commercial	$22.54
Rate for Payer: Fidelis Medicare Advantage	$47.33
Rate for Payer: Group Health Inc Commercial	$22.54
Rate for Payer: Group Health Inc Medicare	$15.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.54
Rate for Payer: Hamaspik Choice Inc Medicare	$22.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$29.30

ZZ ANGIODYN 5F OMNFLUSH

Facility

$45.08

Service Code	HCPCS C1725
Hospital Charge Code	41569600
Hospital Revenue Code	278
Min. Negotiated Rate	$22.54
Max. Negotiated Rate	$22.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.54
Rate for Payer: Hamaspik Choice Inc Medicare	$22.54

ZZ ANGIODYN 5F STRFLUSH

Facility

$35.44

Service Code	HCPCS C1725
Hospital Charge Code	41569601
Hospital Revenue Code	278
Min. Negotiated Rate	$12.40
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$21.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.38
Rate for Payer: EmblemHealth Commercial	$17.72
Rate for Payer: Fidelis Medicare Advantage	$37.21
Rate for Payer: Group Health Inc Commercial	$17.72
Rate for Payer: Group Health Inc Medicare	$12.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.72
Rate for Payer: Hamaspik Choice Inc Medicare	$17.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23.04

ZZ ANGIODYN 5F STRFLUSH

Facility

$35.44

Service Code	HCPCS C1725
Hospital Charge Code	41569601
Hospital Revenue Code	278
Min. Negotiated Rate	$17.72
Max. Negotiated Rate	$17.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.72
Rate for Payer: Hamaspik Choice Inc Medicare	$17.72

ZZ ANGIOGRAPHY KIT

Facility

$89.66

Hospital Charge Code	41567000
Hospital Revenue Code	270
Min. Negotiated Rate	$31.38
Max. Negotiated Rate	$71.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.83
Rate for Payer: Aetna Government	$44.83
Rate for Payer: Brighton Health Commercial	$67.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.97
Rate for Payer: Group Health Inc Commercial	$44.83
Rate for Payer: Group Health Inc Medicare	$31.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.83
Rate for Payer: Hamaspik Choice Inc Medicare	$44.83

ZZ ANGIO-SEAL 6F

Facility

$580.00

Service Code	HCPCS C1760
Hospital Charge Code	41561951
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$609.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$319.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.50
Rate for Payer: Aetna Government	$73.50
Rate for Payer: Brighton Health Commercial	$348.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$290.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$333.50
Rate for Payer: EmblemHealth Commercial	$290.00
Rate for Payer: Fidelis Medicare Advantage	$609.00
Rate for Payer: Group Health Inc Commercial	$290.00
Rate for Payer: Group Health Inc Medicare	$203.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.00
Rate for Payer: Hamaspik Choice Inc Medicare	$290.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$377.00

ZZ ANGIO-SEAL 6F

Facility

$580.00

Service Code	HCPCS C1760
Hospital Charge Code	41561951
Hospital Revenue Code	278
Min. Negotiated Rate	$290.00
Max. Negotiated Rate	$290.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.00
Rate for Payer: Hamaspik Choice Inc Medicare	$290.00

ZZ ANGIOTECH NEEDLE GUIDE

Facility

$26.00

Hospital Charge Code	41564610
Hospital Revenue Code	272
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: Brighton Health Commercial	$19.50
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

Know your out-of-pocket cost for care.

All Charges