St. Barnabas Hospital

All Charges

Charge

Type

Price

CATH > 400.00

Facility IP

$1,096.67

Service Code	HCPCS C1725
Hospital Charge Code	40203023
Hospital Revenue Code	278
Min. Negotiated Rate	$548.34
Max. Negotiated Rate	$548.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$548.34
Rate for Payer: Hamaspik Choice Inc Medicare	$548.34

CATH > 400.00

Facility OP

$1,096.67

Service Code	HCPCS C1725
Hospital Charge Code	40203023
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$1,151.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$603.17
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	$548.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$630.59
Rate for Payer: Fidelis Medicare Advantage	$1,151.50
Rate for Payer: Group Health Inc Commercial	$548.34
Rate for Payer: Group Health Inc Medicare	$383.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$548.34
Rate for Payer: Hamaspik Choice Inc Medicare	$548.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$712.84

CATH 4.0-35-65-P RIM CATH 65MM

Facility OP

$37.15

Hospital Charge Code	64905030
Hospital Revenue Code	279
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$29.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.58
Rate for Payer: Aetna Government	$18.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.26
Rate for Payer: Group Health Inc Commercial	$18.58
Rate for Payer: Group Health Inc Medicare	$13.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.58
Rate for Payer: Hamaspik Choice Inc Medicare	$18.58

CATH ANGIO .035 100CM

Facility OP

$964.00

Hospital Charge Code	64906167
Hospital Revenue Code	279
Min. Negotiated Rate	$337.40
Max. Negotiated Rate	$771.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$530.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$482.00
Rate for Payer: Aetna Government	$482.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$771.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$655.52
Rate for Payer: Group Health Inc Commercial	$482.00
Rate for Payer: Group Health Inc Medicare	$337.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$482.00
Rate for Payer: Hamaspik Choice Inc Medicare	$482.00

CATH ANGIO 5FR 65CML

Facility OP

$37.15

Hospital Charge Code	64905206
Hospital Revenue Code	279
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$29.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.58
Rate for Payer: Aetna Government	$18.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.26
Rate for Payer: Group Health Inc Commercial	$18.58
Rate for Payer: Group Health Inc Medicare	$13.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.58
Rate for Payer: Hamaspik Choice Inc Medicare	$18.58

CATH ANGIO 5FR BERN .035 100

Facility OP

$65.50

Service Code	HCPCS C1757
Hospital Charge Code	64906258
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$68.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.33
Rate for Payer: Aetna Government	$16.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.66
Rate for Payer: Fidelis Medicare Advantage	$68.78
Rate for Payer: Group Health Inc Commercial	$32.75
Rate for Payer: Group Health Inc Medicare	$22.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.75
Rate for Payer: Hamaspik Choice Inc Medicare	$32.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$42.58

CATH ANGIO 5FR BERN .035 100

Facility IP

$65.50

Service Code	HCPCS C1757
Hospital Charge Code	64906258
Hospital Revenue Code	278
Min. Negotiated Rate	$32.75
Max. Negotiated Rate	$32.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.75
Rate for Payer: Hamaspik Choice Inc Medicare	$32.75

CATH ANGIO 5 X 20CM 20MM D

Facility OP

$425.00

Hospital Charge Code	64905208
Hospital Revenue Code	279
Min. Negotiated Rate	$148.75
Max. Negotiated Rate	$340.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$233.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$212.50
Rate for Payer: Aetna Government	$212.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$340.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$289.00
Rate for Payer: Group Health Inc Commercial	$212.50
Rate for Payer: Group Health Inc Medicare	$148.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$212.50
Rate for Payer: Hamaspik Choice Inc Medicare	$212.50

CATH ARGYLE TROCAR 20 FR

Facility OP

$411.88

Hospital Charge Code	64902665
Hospital Revenue Code	279
Min. Negotiated Rate	$144.16
Max. Negotiated Rate	$329.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$226.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$205.94
Rate for Payer: Aetna Government	$205.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$329.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$280.08
Rate for Payer: Group Health Inc Commercial	$205.94
Rate for Payer: Group Health Inc Medicare	$144.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$205.94
Rate for Payer: Hamaspik Choice Inc Medicare	$205.94

CATH ARTERIAL EMBOLECTOMY 3FR

Facility OP

$95.50

Hospital Charge Code	40202172
Hospital Revenue Code	270
Min. Negotiated Rate	$33.42
Max. Negotiated Rate	$76.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$52.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$47.75
Rate for Payer: Aetna Government	$47.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$76.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.94
Rate for Payer: Group Health Inc Commercial	$47.75
Rate for Payer: Group Health Inc Medicare	$33.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.75
Rate for Payer: Hamaspik Choice Inc Medicare	$47.75

CATH BAL ADM 5X120MMX130CM 6F

Facility IP

$1,560.00

Service Code	HCPCS C1725
Hospital Charge Code	64906286
Hospital Revenue Code	278
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$780.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$780.00
Rate for Payer: Hamaspik Choice Inc Medicare	$780.00

CATH BAL ADM 5X120MMX130CM 6F

Facility OP

$1,560.00

Service Code	HCPCS C1725
Hospital Charge Code	64906286
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$1,638.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$858.00
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	$780.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$897.00
Rate for Payer: Fidelis Medicare Advantage	$1,638.00
Rate for Payer: Group Health Inc Commercial	$780.00
Rate for Payer: Group Health Inc Medicare	$546.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$780.00
Rate for Payer: Hamaspik Choice Inc Medicare	$780.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,014.00

CATH BALL ATLAS PTA .035 14X40

Facility IP

$1,182.00

Service Code	HCPCS C1725
Hospital Charge Code	40004786
Hospital Revenue Code	278
Min. Negotiated Rate	$591.00
Max. Negotiated Rate	$591.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$591.00
Rate for Payer: Hamaspik Choice Inc Medicare	$591.00

CATH BALL ATLAS PTA .035 14X40

Facility OP

$1,182.00

Service Code	HCPCS C1725
Hospital Charge Code	40004786
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$1,241.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$650.10
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	$591.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$679.65
Rate for Payer: Fidelis Medicare Advantage	$1,241.10
Rate for Payer: Group Health Inc Commercial	$591.00
Rate for Payer: Group Health Inc Medicare	$413.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$591.00
Rate for Payer: Hamaspik Choice Inc Medicare	$591.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$768.30

CATH BALL CHOC PTA 3.5X80MX135CM

Facility IP

$900.00

Service Code	HCPCS C1725
Hospital Charge Code	64906525
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00

CATH BALL CHOC PTA 3.5X80MX135CM

Facility OP

$900.00

Service Code	HCPCS C1725
Hospital Charge Code	64906525
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$945.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$495.00
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	$450.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$517.50
Rate for Payer: Fidelis Medicare Advantage	$945.00
Rate for Payer: Group Health Inc Commercial	$450.00
Rate for Payer: Group Health Inc Medicare	$315.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$585.00

CATH BALLOON 18FR #225-122 UROMAX

Facility OP

$464.00

Hospital Charge Code	40209786
Hospital Revenue Code	270
Min. Negotiated Rate	$162.40
Max. Negotiated Rate	$371.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$255.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$232.00
Rate for Payer: Aetna Government	$232.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$371.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$315.52
Rate for Payer: Group Health Inc Commercial	$232.00
Rate for Payer: Group Health Inc Medicare	$162.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$232.00
Rate for Payer: Hamaspik Choice Inc Medicare	$232.00

CATH BALLOON 35LP 5FR

Facility OP

$450.00

Hospital Charge Code	64906023
Hospital Revenue Code	279
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$360.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$225.00
Rate for Payer: Aetna Government	$225.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$360.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$306.00
Rate for Payer: Group Health Inc Commercial	$225.00
Rate for Payer: Group Health Inc Medicare	$157.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.00
Rate for Payer: Hamaspik Choice Inc Medicare	$225.00

CATH BALLOON 5FR 8MM

Facility OP

$570.00

Hospital Charge Code	40209784
Hospital Revenue Code	270
Min. Negotiated Rate	$199.50
Max. Negotiated Rate	$456.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$313.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$285.00
Rate for Payer: Aetna Government	$285.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$387.60
Rate for Payer: Group Health Inc Commercial	$285.00
Rate for Payer: Group Health Inc Medicare	$199.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$285.00
Rate for Payer: Hamaspik Choice Inc Medicare	$285.00

CATH BALLOON VIA 6X39X80CM

Facility OP

$8,137.50

Hospital Charge Code	64906135
Hospital Revenue Code	279
Min. Negotiated Rate	$2,848.12
Max. Negotiated Rate	$6,510.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,475.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,068.75
Rate for Payer: Aetna Government	$4,068.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,510.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,533.50
Rate for Payer: Group Health Inc Commercial	$4,068.75
Rate for Payer: Group Health Inc Medicare	$2,848.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,068.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,068.75

CATH BALLOON VIA 6X59X80CM

Facility OP

$8,137.50

Hospital Charge Code	64906136
Hospital Revenue Code	279
Min. Negotiated Rate	$2,848.12
Max. Negotiated Rate	$6,510.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,475.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,068.75
Rate for Payer: Aetna Government	$4,068.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,510.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,533.50
Rate for Payer: Group Health Inc Commercial	$4,068.75
Rate for Payer: Group Health Inc Medicare	$2,848.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,068.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,068.75

CATH BALLOON VIA 8X39.X80CM

Facility OP

$8,137.50

Hospital Charge Code	64906137
Hospital Revenue Code	279
Min. Negotiated Rate	$2,848.12
Max. Negotiated Rate	$6,510.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,475.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,068.75
Rate for Payer: Aetna Government	$4,068.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,510.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,533.50
Rate for Payer: Group Health Inc Commercial	$4,068.75
Rate for Payer: Group Health Inc Medicare	$2,848.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,068.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,068.75

CATH BALLOON VIA 8X59X80CM

Facility OP

$8,137.50

Hospital Charge Code	64906138
Hospital Revenue Code	279
Min. Negotiated Rate	$2,848.12
Max. Negotiated Rate	$6,510.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,475.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,068.75
Rate for Payer: Aetna Government	$4,068.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,510.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,533.50
Rate for Payer: Group Health Inc Commercial	$4,068.75
Rate for Payer: Group Health Inc Medicare	$2,848.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,068.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,068.75

CATH BAL NANO .014 2X100MMX150CM

Facility OP

$300.00

Service Code	HCPCS C1725
Hospital Charge Code	64906282
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$315.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
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	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

CATH BAL NANO .014 2X100MMX150CM

Facility IP

$300.00

Service Code	HCPCS C1725
Hospital Charge Code	64906282
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

Price Transparency.

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