St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ BELLY BAG/UNILATERAL

Facility

$23.21

Hospital Charge Code	41569459
Hospital Revenue Code	270
Min. Negotiated Rate	$8.12
Max. Negotiated Rate	$18.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.60
Rate for Payer: Aetna Government	$11.60
Rate for Payer: Brighton Health Commercial	$17.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.78
Rate for Payer: Group Health Inc Commercial	$11.60
Rate for Payer: Group Health Inc Medicare	$8.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.60
Rate for Payer: Hamaspik Choice Inc Medicare	$11.60

ZZ BERENSTEIN CATH 5 40

Facility

$48.91

Service Code	HCPCS C1725
Hospital Charge Code	41567170
Hospital Revenue Code	278
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$51.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$29.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.12
Rate for Payer: EmblemHealth Commercial	$24.46
Rate for Payer: Fidelis Medicare Advantage	$51.36
Rate for Payer: Group Health Inc Commercial	$24.46
Rate for Payer: Group Health Inc Medicare	$17.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.79

ZZ BERENSTEIN CATH 5 40

Facility

$48.91

Service Code	HCPCS C1725
Hospital Charge Code	41567170
Hospital Revenue Code	278
Min. Negotiated Rate	$24.46
Max. Negotiated Rate	$24.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46

ZZ BERENSTEIN CATH 5 65

Facility

$48.91

Service Code	HCPCS C1725
Hospital Charge Code	41567169
Hospital Revenue Code	278
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$51.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$29.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.12
Rate for Payer: EmblemHealth Commercial	$24.46
Rate for Payer: Fidelis Medicare Advantage	$51.36
Rate for Payer: Group Health Inc Commercial	$24.46
Rate for Payer: Group Health Inc Medicare	$17.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.79

ZZ BERENSTEIN CATH 5 65

Facility

$48.91

Service Code	HCPCS C1725
Hospital Charge Code	41567169
Hospital Revenue Code	278
Min. Negotiated Rate	$24.46
Max. Negotiated Rate	$24.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46

ZZ BETSON WR TSFB 35 145

Facility

$49.97

Service Code	HCPCS C1769
Hospital Charge Code	41567092
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$52.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$29.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.73
Rate for Payer: EmblemHealth Commercial	$24.98
Rate for Payer: Fidelis Medicare Advantage	$52.47
Rate for Payer: Group Health Inc Commercial	$24.98
Rate for Payer: Group Health Inc Medicare	$17.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.98
Rate for Payer: Hamaspik Choice Inc Medicare	$24.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.48

ZZ BETSON WR TSFB 35 145

Facility

$49.97

Service Code	HCPCS C1769
Hospital Charge Code	41567092
Hospital Revenue Code	278
Min. Negotiated Rate	$24.98
Max. Negotiated Rate	$24.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.98
Rate for Payer: Hamaspik Choice Inc Medicare	$24.98

ZZ BILIAR CTH AMPLA 10/30

Facility

$231.41

Service Code	HCPCS C1725
Hospital Charge Code	41567223
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$242.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$127.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$138.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$115.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$133.06
Rate for Payer: EmblemHealth Commercial	$115.70
Rate for Payer: Fidelis Medicare Advantage	$242.98
Rate for Payer: Group Health Inc Commercial	$115.70
Rate for Payer: Group Health Inc Medicare	$80.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.70
Rate for Payer: Hamaspik Choice Inc Medicare	$115.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$150.42

ZZ BILIAR CTH AMPLA 10/30

Facility

$231.41

Service Code	HCPCS C1725
Hospital Charge Code	41567223
Hospital Revenue Code	278
Min. Negotiated Rate	$115.70
Max. Negotiated Rate	$115.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.70
Rate for Payer: Hamaspik Choice Inc Medicare	$115.70

ZZ BILIAR CTH AMPLA 12/30

Facility

$231.41

Service Code	HCPCS C1725
Hospital Charge Code	41567224
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$242.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$127.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$138.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$115.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$133.06
Rate for Payer: EmblemHealth Commercial	$115.70
Rate for Payer: Fidelis Medicare Advantage	$242.98
Rate for Payer: Group Health Inc Commercial	$115.70
Rate for Payer: Group Health Inc Medicare	$80.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.70
Rate for Payer: Hamaspik Choice Inc Medicare	$115.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$150.42

ZZ BILIAR CTH AMPLA 12/30

Facility

$231.41

Service Code	HCPCS C1725
Hospital Charge Code	41567224
Hospital Revenue Code	278
Min. Negotiated Rate	$115.70
Max. Negotiated Rate	$115.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.70
Rate for Payer: Hamaspik Choice Inc Medicare	$115.70

ZZ BILIAR CTH AMPLA 8/30

Facility

$231.41

Service Code	HCPCS C1725
Hospital Charge Code	41567222
Hospital Revenue Code	278
Min. Negotiated Rate	$115.70
Max. Negotiated Rate	$115.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.70
Rate for Payer: Hamaspik Choice Inc Medicare	$115.70

ZZ BILIAR CTH AMPLA 8/30

Facility

$231.41

Service Code	HCPCS C1725
Hospital Charge Code	41567222
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$242.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$127.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$138.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$115.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$133.06
Rate for Payer: EmblemHealth Commercial	$115.70
Rate for Payer: Fidelis Medicare Advantage	$242.98
Rate for Payer: Group Health Inc Commercial	$115.70
Rate for Payer: Group Health Inc Medicare	$80.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.70
Rate for Payer: Hamaspik Choice Inc Medicare	$115.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$150.42

ZZ BILIAR DRAIN CATH 8/35

Facility

$238.14

Service Code	HCPCS C1725
Hospital Charge Code	41567220
Hospital Revenue Code	278
Min. Negotiated Rate	$119.07
Max. Negotiated Rate	$119.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.07
Rate for Payer: Hamaspik Choice Inc Medicare	$119.07

ZZ BILIAR DRAIN CATH 8/35

Facility

$238.14

Service Code	HCPCS C1725
Hospital Charge Code	41567220
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$250.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$142.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$119.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.93
Rate for Payer: EmblemHealth Commercial	$119.07
Rate for Payer: Fidelis Medicare Advantage	$250.05
Rate for Payer: Group Health Inc Commercial	$119.07
Rate for Payer: Group Health Inc Medicare	$83.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.07
Rate for Payer: Hamaspik Choice Inc Medicare	$119.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$154.79

ZZ BILIAR DRN CATH 10/35

Facility

$238.14

Service Code	HCPCS C1725
Hospital Charge Code	41567221
Hospital Revenue Code	278
Min. Negotiated Rate	$119.07
Max. Negotiated Rate	$119.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.07
Rate for Payer: Hamaspik Choice Inc Medicare	$119.07

ZZ BILIAR DRN CATH 10/35

Facility

$238.14

Service Code	HCPCS C1725
Hospital Charge Code	41567221
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$250.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$142.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$119.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.93
Rate for Payer: EmblemHealth Commercial	$119.07
Rate for Payer: Fidelis Medicare Advantage	$250.05
Rate for Payer: Group Health Inc Commercial	$119.07
Rate for Payer: Group Health Inc Medicare	$83.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.07
Rate for Payer: Hamaspik Choice Inc Medicare	$119.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$154.79

ZZ BIO NDK QK CR 10 5 10

Facility

$87.89

Hospital Charge Code	41567065
Hospital Revenue Code	270
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$70.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.94
Rate for Payer: Aetna Government	$43.94
Rate for Payer: Brighton Health Commercial	$65.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.77
Rate for Payer: Group Health Inc Commercial	$43.94
Rate for Payer: Group Health Inc Medicare	$30.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.94
Rate for Payer: Hamaspik Choice Inc Medicare	$43.94

ZZ BIO NDL QK CR 18 15 10

Facility

$87.89

Hospital Charge Code	41567066
Hospital Revenue Code	270
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$70.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.94
Rate for Payer: Aetna Government	$43.94
Rate for Payer: Brighton Health Commercial	$65.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.77
Rate for Payer: Group Health Inc Commercial	$43.94
Rate for Payer: Group Health Inc Medicare	$30.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.94
Rate for Payer: Hamaspik Choice Inc Medicare	$43.94

ZZ BIO NDL QK CR 18 15 20

Facility

$87.89

Hospital Charge Code	41567067
Hospital Revenue Code	270
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$70.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.94
Rate for Payer: Aetna Government	$43.94
Rate for Payer: Brighton Health Commercial	$65.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.77
Rate for Payer: Group Health Inc Commercial	$43.94
Rate for Payer: Group Health Inc Medicare	$30.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.94
Rate for Payer: Hamaspik Choice Inc Medicare	$43.94

ZZ BIO NDL QK CR 18 20 20

Facility

$87.89

Hospital Charge Code	41567068
Hospital Revenue Code	270
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$70.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.94
Rate for Payer: Aetna Government	$43.94
Rate for Payer: Brighton Health Commercial	$65.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.77
Rate for Payer: Group Health Inc Commercial	$43.94
Rate for Payer: Group Health Inc Medicare	$30.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.94
Rate for Payer: Hamaspik Choice Inc Medicare	$43.94

ZZ BIO NDL QK CR 18 6 10

Facility

$87.89

Hospital Charge Code	41567069
Hospital Revenue Code	270
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$70.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.94
Rate for Payer: Aetna Government	$43.94
Rate for Payer: Brighton Health Commercial	$65.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.77
Rate for Payer: Group Health Inc Commercial	$43.94
Rate for Payer: Group Health Inc Medicare	$30.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.94
Rate for Payer: Hamaspik Choice Inc Medicare	$43.94

ZZ BIO NDL QK CR 18 9 10

Facility

$87.89

Hospital Charge Code	41567070
Hospital Revenue Code	270
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$70.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.94
Rate for Payer: Aetna Government	$43.94
Rate for Payer: Brighton Health Commercial	$65.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.77
Rate for Payer: Group Health Inc Commercial	$43.94
Rate for Payer: Group Health Inc Medicare	$30.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.94
Rate for Payer: Hamaspik Choice Inc Medicare	$43.94

ZZ BIO NDL QK CR 19 15 10

Facility

$87.89

Hospital Charge Code	41567072
Hospital Revenue Code	270
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$70.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.94
Rate for Payer: Aetna Government	$43.94
Rate for Payer: Brighton Health Commercial	$65.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.77
Rate for Payer: Group Health Inc Commercial	$43.94
Rate for Payer: Group Health Inc Medicare	$30.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.94
Rate for Payer: Hamaspik Choice Inc Medicare	$43.94

ZZ BIO NDL QK CR 19 15 20

Facility

$87.89

Hospital Charge Code	41567073
Hospital Revenue Code	270
Min. Negotiated Rate	$30.76
Max. Negotiated Rate	$70.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.94
Rate for Payer: Aetna Government	$43.94
Rate for Payer: Brighton Health Commercial	$65.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.77
Rate for Payer: Group Health Inc Commercial	$43.94
Rate for Payer: Group Health Inc Medicare	$30.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.94
Rate for Payer: Hamaspik Choice Inc Medicare	$43.94

Know your out-of-pocket cost for care.

All Charges