St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ BARD PH 9.5FR

Facility

$1,172.00

Service Code	HCPCS C1751
Hospital Charge Code	41561917
Hospital Revenue Code	278
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$1,230.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$644.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.08
Rate for Payer: Aetna Government	$7.08
Rate for Payer: Brighton Health Commercial	$703.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$586.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$673.90
Rate for Payer: EmblemHealth Commercial	$586.00
Rate for Payer: Fidelis Medicare Advantage	$1,230.60
Rate for Payer: Group Health Inc Commercial	$586.00
Rate for Payer: Group Health Inc Medicare	$410.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.00
Rate for Payer: Hamaspik Choice Inc Medicare	$586.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$761.80

ZZ BARD PH 9.5FR

Facility

$1,172.00

Service Code	HCPCS C1751
Hospital Charge Code	41561917
Hospital Revenue Code	278
Min. Negotiated Rate	$586.00
Max. Negotiated Rate	$586.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.00
Rate for Payer: Hamaspik Choice Inc Medicare	$586.00

ZZ BARD POWERGLIDE CATHETER

Facility

$104.00

Hospital Charge Code	41561361
Hospital Revenue Code	272
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$83.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$52.00
Rate for Payer: Aetna Government	$52.00
Rate for Payer: Brighton Health Commercial	$78.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$83.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$70.72
Rate for Payer: Group Health Inc Commercial	$52.00
Rate for Payer: Group Health Inc Medicare	$36.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00

ZZ BARD POWERPORT CLEARVUE

Facility

$500.00

Service Code	HCPCS C1788
Hospital Charge Code	41563105
Hospital Revenue Code	278
Min. Negotiated Rate	$250.00
Max. Negotiated Rate	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

ZZ BARD POWERPORT CLEARVUE

Facility

$500.00

Service Code	HCPCS C1788
Hospital Charge Code	41563105
Hospital Revenue Code	278
Min. Negotiated Rate	$19.03
Max. Negotiated Rate	$525.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.03
Rate for Payer: Aetna Government	$19.03
Rate for Payer: Brighton Health Commercial	$300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.50
Rate for Payer: EmblemHealth Commercial	$250.00
Rate for Payer: Fidelis Medicare Advantage	$525.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$325.00

ZZ BARD PTA CATH 12MMX4CM

Facility

$260.00

Hospital Charge Code	41564608
Hospital Revenue Code	272
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$208.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Brighton Health Commercial	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00

ZZ BARD RECOVERY CONE SYS.

Facility

$1,249.50

Hospital Charge Code	41569865
Hospital Revenue Code	270
Min. Negotiated Rate	$437.32
Max. Negotiated Rate	$999.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$687.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$624.75
Rate for Payer: Aetna Government	$624.75
Rate for Payer: Brighton Health Commercial	$937.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$999.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$849.66
Rate for Payer: Group Health Inc Commercial	$624.75
Rate for Payer: Group Health Inc Medicare	$437.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.75
Rate for Payer: Hamaspik Choice Inc Medicare	$624.75

ZZ BARD RECOVERY FILTER SYSTEM

Facility

$3,954.83

Hospital Charge Code	41569820
Hospital Revenue Code	270
Min. Negotiated Rate	$1,384.19
Max. Negotiated Rate	$3,163.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,175.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,977.42
Rate for Payer: Aetna Government	$1,977.42
Rate for Payer: Brighton Health Commercial	$2,966.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,163.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,689.28
Rate for Payer: Group Health Inc Commercial	$1,977.42
Rate for Payer: Group Health Inc Medicare	$1,384.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,977.42
Rate for Payer: Hamaspik Choice Inc Medicare	$1,977.42

ZZ BARDSPORT SLIM TITM SNG LUMEN

Facility

$840.00

Service Code	HCPCS C1725
Hospital Charge Code	41569832
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$420.00
Rate for Payer: Hamaspik Choice Inc Medicare	$420.00

ZZ BARDSPORT SLIM TITM SNG LUMEN

Facility

$840.00

Service Code	HCPCS C1725
Hospital Charge Code	41569832
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$882.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$462.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$504.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$420.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$483.00
Rate for Payer: EmblemHealth Commercial	$420.00
Rate for Payer: Fidelis Medicare Advantage	$882.00
Rate for Payer: Group Health Inc Commercial	$420.00
Rate for Payer: Group Health Inc Medicare	$294.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$420.00
Rate for Payer: Hamaspik Choice Inc Medicare	$420.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$546.00

ZZ BARD STENT FLEXX

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569540
Hospital Revenue Code	278
Min. Negotiated Rate	$1,701.00
Max. Negotiated Rate	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00

ZZ BARD STENT FLEXX

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569540
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,572.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,871.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,041.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,701.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,956.15
Rate for Payer: EmblemHealth Commercial	$1,701.00
Rate for Payer: Fidelis Medicare Advantage	$3,572.10
Rate for Payer: Group Health Inc Commercial	$1,701.00
Rate for Payer: Group Health Inc Medicare	$1,190.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,211.30

ZZ BARD TRACHEOBRONC STENT GRAFT

Facility

$5,700.00

Service Code	HCPCS C1874
Hospital Charge Code	66520353
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 TRACHEOBRONC STENT GRAFT

Facility

$5,700.00

Service Code	HCPCS C1874
Hospital Charge Code	66520353
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$5,985.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,135.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
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 UNIV DRAINAGE BAG

Facility

$22.18

Hospital Charge Code	41569881
Hospital Revenue Code	270
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$17.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.09
Rate for Payer: Aetna Government	$11.09
Rate for Payer: Brighton Health Commercial	$16.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.08
Rate for Payer: Group Health Inc Commercial	$11.09
Rate for Payer: Group Health Inc Medicare	$7.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.09
Rate for Payer: Hamaspik Choice Inc Medicare	$11.09

ZZ BARD X-PORT 6FR

Facility

$661.50

Service Code	HCPCS C1725
Hospital Charge Code	41567895
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$694.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$363.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$396.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$330.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$380.36
Rate for Payer: EmblemHealth Commercial	$330.75
Rate for Payer: Fidelis Medicare Advantage	$694.58
Rate for Payer: Group Health Inc Commercial	$330.75
Rate for Payer: Group Health Inc Medicare	$231.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.75
Rate for Payer: Hamaspik Choice Inc Medicare	$330.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$429.98

ZZ BARD X-PORT 6FR

Facility

$661.50

Service Code	HCPCS C1725
Hospital Charge Code	41567895
Hospital Revenue Code	278
Min. Negotiated Rate	$330.75
Max. Negotiated Rate	$330.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.75
Rate for Payer: Hamaspik Choice Inc Medicare	$330.75

ZZ BARIUM SULFATE GM 50ML VIAL

Facility

$198.45

Hospital Charge Code	41569724
Hospital Revenue Code	270
Min. Negotiated Rate	$69.46
Max. Negotiated Rate	$158.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$109.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$99.22
Rate for Payer: Aetna Government	$99.22
Rate for Payer: Brighton Health Commercial	$148.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$158.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.95
Rate for Payer: Group Health Inc Commercial	$99.22
Rate for Payer: Group Health Inc Medicare	$69.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$99.22
Rate for Payer: Hamaspik Choice Inc Medicare	$99.22

ZZ BASKET/1.5CM/3CM LENGHT/8 WIRE

Facility

$422.30

Hospital Charge Code	41569453
Hospital Revenue Code	270
Min. Negotiated Rate	$147.80
Max. Negotiated Rate	$337.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$232.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$211.15
Rate for Payer: Aetna Government	$211.15
Rate for Payer: Brighton Health Commercial	$316.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$337.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.16
Rate for Payer: Group Health Inc Commercial	$211.15
Rate for Payer: Group Health Inc Medicare	$147.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$211.15
Rate for Payer: Hamaspik Choice Inc Medicare	$211.15

ZZ BASKET/6.3F/55CM/BIL/STONE

Facility

$487.24

Hospital Charge Code	41569454
Hospital Revenue Code	270
Min. Negotiated Rate	$170.53
Max. Negotiated Rate	$389.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$267.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$243.62
Rate for Payer: Aetna Government	$243.62
Rate for Payer: Brighton Health Commercial	$365.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$389.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$331.32
Rate for Payer: Group Health Inc Commercial	$243.62
Rate for Payer: Group Health Inc Medicare	$170.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.62
Rate for Payer: Hamaspik Choice Inc Medicare	$243.62

ZZ BASKET/6.5F/55CM/BIL/STONE

Facility

$487.24

Hospital Charge Code	41569456
Hospital Revenue Code	270
Min. Negotiated Rate	$170.53
Max. Negotiated Rate	$389.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$267.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$243.62
Rate for Payer: Aetna Government	$243.62
Rate for Payer: Brighton Health Commercial	$365.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$389.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$331.32
Rate for Payer: Group Health Inc Commercial	$243.62
Rate for Payer: Group Health Inc Medicare	$170.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.62
Rate for Payer: Hamaspik Choice Inc Medicare	$243.62

ZZ BASKET/HELICAL/2.5F/115CM

Facility

$214.49

Hospital Charge Code	41569457
Hospital Revenue Code	270
Min. Negotiated Rate	$75.07
Max. Negotiated Rate	$171.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$117.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$107.24
Rate for Payer: Aetna Government	$107.24
Rate for Payer: Brighton Health Commercial	$160.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$171.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$145.85
Rate for Payer: Group Health Inc Commercial	$107.24
Rate for Payer: Group Health Inc Medicare	$75.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$107.24
Rate for Payer: Hamaspik Choice Inc Medicare	$107.24

ZZ BAXTER ADHERENT CLOT CATH

Facility

$552.83

Hospital Charge Code	41569625
Hospital Revenue Code	270
Min. Negotiated Rate	$193.49
Max. Negotiated Rate	$442.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$304.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$276.42
Rate for Payer: Aetna Government	$276.42
Rate for Payer: Brighton Health Commercial	$414.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$442.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$375.92
Rate for Payer: Group Health Inc Commercial	$276.42
Rate for Payer: Group Health Inc Medicare	$193.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$276.42
Rate for Payer: Hamaspik Choice Inc Medicare	$276.42

ZZ BD NEXIVA DIFFUSICS

Facility

$20.00

Hospital Charge Code	66520350
Hospital Revenue Code	270
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$16.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.00
Rate for Payer: Aetna Government	$10.00
Rate for Payer: Brighton Health Commercial	$15.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.60
Rate for Payer: Group Health Inc Commercial	$10.00
Rate for Payer: Group Health Inc Medicare	$7.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.00
Rate for Payer: Hamaspik Choice Inc Medicare	$10.00

ZZ BELLY BAG/BILATERAL

Facility

$25.26

Hospital Charge Code	41569458
Hospital Revenue Code	270
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$20.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.63
Rate for Payer: Aetna Government	$12.63
Rate for Payer: Brighton Health Commercial	$18.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.18
Rate for Payer: Group Health Inc Commercial	$12.63
Rate for Payer: Group Health Inc Medicare	$8.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.63
Rate for Payer: Hamaspik Choice Inc Medicare	$12.63

Know your out-of-pocket cost for care.

All Charges