St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ BARD FLEXX STNT PBM 7X40

Facility

$3,118.50

Service Code	HCPCS C1876
Hospital Charge Code	41569555
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,274.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,715.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,871.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,559.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,793.14
Rate for Payer: EmblemHealth Commercial	$1,559.25
Rate for Payer: Fidelis Medicare Advantage	$3,274.42
Rate for Payer: Group Health Inc Commercial	$1,559.25
Rate for Payer: Group Health Inc Medicare	$1,091.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,559.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,559.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,027.02

ZZ BARD FLEXX STNT PBM 7X40

Facility

$3,118.50

Service Code	HCPCS C1876
Hospital Charge Code	41569555
Hospital Revenue Code	278
Min. Negotiated Rate	$1,559.25
Max. Negotiated Rate	$1,559.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,559.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,559.25

ZZ BARD FLUENCY PLUS 8X40MM

Facility

$5,700.00

Service Code	HCPCS C1876
Hospital Charge Code	41563104
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$2,850.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,850.00

ZZ BARD FLUENCY PLUS 8X40MM

Facility

$5,700.00

Service Code	HCPCS C1876
Hospital Charge Code	41563104
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$5,985.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,135.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$3,420.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,850.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,277.50
Rate for Payer: EmblemHealth Commercial	$2,850.00
Rate for Payer: Fidelis Medicare Advantage	$5,985.00
Rate for Payer: Group Health Inc Commercial	$2,850.00
Rate for Payer: Group Health Inc Medicare	$1,995.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,850.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,705.00

ZZ BARD FLUENCY TRACBR STNGRF9X40

Facility

$4,399.50

Service Code	HCPCS C1876
Hospital Charge Code	41569882
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,619.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,419.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,639.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,199.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,529.71
Rate for Payer: EmblemHealth Commercial	$2,199.75
Rate for Payer: Fidelis Medicare Advantage	$4,619.48
Rate for Payer: Group Health Inc Commercial	$2,199.75
Rate for Payer: Group Health Inc Medicare	$1,539.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,199.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,199.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,859.68

ZZ BARD FLUENCY TRACBR STNGRF9X40

Facility

$4,399.50

Service Code	HCPCS C1876
Hospital Charge Code	41569882
Hospital Revenue Code	278
Min. Negotiated Rate	$2,199.75
Max. Negotiated Rate	$2,199.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,199.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,199.75

ZZ BARD GATROSTOMY TUBE 14F

Facility

$122.00

Hospital Charge Code	41567763
Hospital Revenue Code	270
Min. Negotiated Rate	$42.70
Max. Negotiated Rate	$97.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$61.00
Rate for Payer: Aetna Government	$61.00
Rate for Payer: Brighton Health Commercial	$91.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.96
Rate for Payer: Group Health Inc Commercial	$61.00
Rate for Payer: Group Health Inc Medicare	$42.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.00
Rate for Payer: Hamaspik Choice Inc Medicare	$61.00

ZZ BARD GLIDEPATH AIRGUARD CATH

Facility

$305.00

Hospital Charge Code	41540607
Hospital Revenue Code	272
Min. Negotiated Rate	$106.75
Max. Negotiated Rate	$244.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$167.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$152.50
Rate for Payer: Aetna Government	$152.50
Rate for Payer: Brighton Health Commercial	$228.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$244.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$207.40
Rate for Payer: Group Health Inc Commercial	$152.50
Rate for Payer: Group Health Inc Medicare	$106.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$152.50
Rate for Payer: Hamaspik Choice Inc Medicare	$152.50

ZZ BARD LUMINEX STNT 8X30

Facility

$3,969.00

Service Code	HCPCS C1876
Hospital Charge Code	41569550
Hospital Revenue Code	278
Min. Negotiated Rate	$1,984.50
Max. Negotiated Rate	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,984.50

ZZ BARD LUMINEX STNT 8X30

Facility

$3,969.00

Service Code	HCPCS C1876
Hospital Charge Code	41569550
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,167.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,182.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,381.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,984.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,282.18
Rate for Payer: EmblemHealth Commercial	$1,984.50
Rate for Payer: Fidelis Medicare Advantage	$4,167.45
Rate for Payer: Group Health Inc Commercial	$1,984.50
Rate for Payer: Group Health Inc Medicare	$1,389.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,984.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,579.85

ZZ BARD LUMINEX STNT 8X40

Facility

$3,969.00

Service Code	HCPCS C1876
Hospital Charge Code	41569549
Hospital Revenue Code	278
Min. Negotiated Rate	$1,984.50
Max. Negotiated Rate	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,984.50

ZZ BARD LUMINEX STNT 8X40

Facility

$3,969.00

Service Code	HCPCS C1876
Hospital Charge Code	41569549
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,167.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,182.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,381.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,984.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,282.18
Rate for Payer: EmblemHealth Commercial	$1,984.50
Rate for Payer: Fidelis Medicare Advantage	$4,167.45
Rate for Payer: Group Health Inc Commercial	$1,984.50
Rate for Payer: Group Health Inc Medicare	$1,389.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,984.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,579.85

ZZ BARD LUMINEX STNT 8X60

Facility

$4,252.50

Service Code	HCPCS C1876
Hospital Charge Code	41569548
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,465.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,338.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,551.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,126.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,445.19
Rate for Payer: EmblemHealth Commercial	$2,126.25
Rate for Payer: Fidelis Medicare Advantage	$4,465.12
Rate for Payer: Group Health Inc Commercial	$2,126.25
Rate for Payer: Group Health Inc Medicare	$1,488.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,126.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,764.12

ZZ BARD LUMINEX STNT 8X60

Facility

$4,252.50

Service Code	HCPCS C1876
Hospital Charge Code	41569548
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,126.25

ZZ BARD LUMNEX STNT 10X40

Facility

$3,969.00

Service Code	HCPCS C1876
Hospital Charge Code	41569553
Hospital Revenue Code	278
Min. Negotiated Rate	$1,984.50
Max. Negotiated Rate	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,984.50

ZZ BARD LUMNEX STNT 10X40

Facility

$3,969.00

Service Code	HCPCS C1876
Hospital Charge Code	41569553
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,167.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,182.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,381.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,984.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,282.18
Rate for Payer: EmblemHealth Commercial	$1,984.50
Rate for Payer: Fidelis Medicare Advantage	$4,167.45
Rate for Payer: Group Health Inc Commercial	$1,984.50
Rate for Payer: Group Health Inc Medicare	$1,389.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,984.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,579.85

ZZ BARD LUMNEX STNT 10X60

Facility

$4,252.50

Service Code	HCPCS C1876
Hospital Charge Code	41569554
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,126.25

ZZ BARD LUMNEX STNT 10X60

Facility

$4,252.50

Service Code	HCPCS C1876
Hospital Charge Code	41569554
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,465.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,338.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,551.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,126.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,445.19
Rate for Payer: EmblemHealth Commercial	$2,126.25
Rate for Payer: Fidelis Medicare Advantage	$4,465.12
Rate for Payer: Group Health Inc Commercial	$2,126.25
Rate for Payer: Group Health Inc Medicare	$1,488.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,126.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,764.12

ZZ BARD LUMNEX STNT 12X40

Facility

$3,969.00

Service Code	HCPCS C1876
Hospital Charge Code	41569551
Hospital Revenue Code	278
Min. Negotiated Rate	$1,984.50
Max. Negotiated Rate	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,984.50

ZZ BARD LUMNEX STNT 12X40

Facility

$3,969.00

Service Code	HCPCS C1876
Hospital Charge Code	41569551
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,167.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,182.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,381.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,984.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,282.18
Rate for Payer: EmblemHealth Commercial	$1,984.50
Rate for Payer: Fidelis Medicare Advantage	$4,167.45
Rate for Payer: Group Health Inc Commercial	$1,984.50
Rate for Payer: Group Health Inc Medicare	$1,389.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,984.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,984.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,579.85

ZZ BARD LUMNEX STNT 12X60

Facility

$4,252.50

Service Code	HCPCS C1876
Hospital Charge Code	41569552
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,465.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,338.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,551.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,126.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,445.19
Rate for Payer: EmblemHealth Commercial	$2,126.25
Rate for Payer: Fidelis Medicare Advantage	$4,465.12
Rate for Payer: Group Health Inc Commercial	$2,126.25
Rate for Payer: Group Health Inc Medicare	$1,488.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,126.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,764.12

ZZ BARD LUMNEX STNT 12X60

Facility

$4,252.50

Service Code	HCPCS C1876
Hospital Charge Code	41569552
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,126.25

ZZ BARD MAX CORE NDL BIOPSY

Facility

$102.06

Hospital Charge Code	41569622
Hospital Revenue Code	270
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$81.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.03
Rate for Payer: Aetna Government	$51.03
Rate for Payer: Brighton Health Commercial	$76.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.40
Rate for Payer: Group Health Inc Commercial	$51.03
Rate for Payer: Group Health Inc Medicare	$35.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.03
Rate for Payer: Hamaspik Choice Inc Medicare	$51.03

ZZ BARD MAX CORE TRU GUIDE

Facility

$36.86

Hospital Charge Code	41569623
Hospital Revenue Code	270
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$29.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.43
Rate for Payer: Aetna Government	$18.43
Rate for Payer: Brighton Health Commercial	$27.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.06
Rate for Payer: Group Health Inc Commercial	$18.43
Rate for Payer: Group Health Inc Medicare	$12.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.43
Rate for Payer: Hamaspik Choice Inc Medicare	$18.43

ZZ BARD MIDLINE KIT

Facility

$283.72

Hospital Charge Code	41543140
Hospital Revenue Code	272
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$226.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$141.86
Rate for Payer: Aetna Government	$141.86
Rate for Payer: Brighton Health Commercial	$212.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$226.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$192.93
Rate for Payer: Group Health Inc Commercial	$141.86
Rate for Payer: Group Health Inc Medicare	$99.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$141.86
Rate for Payer: Hamaspik Choice Inc Medicare	$141.86

Know your out-of-pocket cost for care.

All Charges