St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ BS WALLSTENT 10X90

Facility

$1,805.76

Service Code	HCPCS C1876
Hospital Charge Code	41541111
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,896.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$993.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,083.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$902.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,038.31
Rate for Payer: EmblemHealth Commercial	$902.88
Rate for Payer: Fidelis Medicare Advantage	$1,896.05
Rate for Payer: Group Health Inc Commercial	$902.88
Rate for Payer: Group Health Inc Medicare	$632.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$902.88
Rate for Payer: Hamaspik Choice Inc Medicare	$902.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,173.74

ZZ BS WALLSTENT 10X90

Facility

$1,805.76

Service Code	HCPCS C1876
Hospital Charge Code	41541111
Hospital Revenue Code	278
Min. Negotiated Rate	$902.88
Max. Negotiated Rate	$902.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$902.88
Rate for Payer: Hamaspik Choice Inc Medicare	$902.88

ZZ BS WALLSTENT 16X60

Facility

$1,063.92

Service Code	HCPCS C1876
Hospital Charge Code	41541113
Hospital Revenue Code	278
Min. Negotiated Rate	$531.96
Max. Negotiated Rate	$531.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$531.96
Rate for Payer: Hamaspik Choice Inc Medicare	$531.96

ZZ BS WALLSTENT 16X60

Facility

$1,063.92

Service Code	HCPCS C1876
Hospital Charge Code	41540619
Hospital Revenue Code	278
Min. Negotiated Rate	$531.96
Max. Negotiated Rate	$531.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$531.96
Rate for Payer: Hamaspik Choice Inc Medicare	$531.96

ZZ BS WALLSTENT 16X60

Facility

$1,063.92

Service Code	HCPCS C1876
Hospital Charge Code	41541113
Hospital Revenue Code	278
Min. Negotiated Rate	$372.37
Max. Negotiated Rate	$1,117.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$585.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$638.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$531.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$611.75
Rate for Payer: EmblemHealth Commercial	$531.96
Rate for Payer: Fidelis Medicare Advantage	$1,117.12
Rate for Payer: Group Health Inc Commercial	$531.96
Rate for Payer: Group Health Inc Medicare	$372.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$531.96
Rate for Payer: Hamaspik Choice Inc Medicare	$531.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$691.55

ZZ BS WALLSTENT 16X60

Facility

$1,063.92

Service Code	HCPCS C1876
Hospital Charge Code	41540619
Hospital Revenue Code	278
Min. Negotiated Rate	$372.37
Max. Negotiated Rate	$1,117.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$585.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$638.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$531.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$611.75
Rate for Payer: EmblemHealth Commercial	$531.96
Rate for Payer: Fidelis Medicare Advantage	$1,117.12
Rate for Payer: Group Health Inc Commercial	$531.96
Rate for Payer: Group Health Inc Medicare	$372.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$531.96
Rate for Payer: Hamaspik Choice Inc Medicare	$531.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$691.55

ZZ BS WALLSTENT 18X90

Facility

$1,805.76

Service Code	HCPCS C1876
Hospital Charge Code	41540618
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,896.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$993.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,083.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$902.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,038.31
Rate for Payer: EmblemHealth Commercial	$902.88
Rate for Payer: Fidelis Medicare Advantage	$1,896.05
Rate for Payer: Group Health Inc Commercial	$902.88
Rate for Payer: Group Health Inc Medicare	$632.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$902.88
Rate for Payer: Hamaspik Choice Inc Medicare	$902.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,173.74

ZZ BS WALLSTENT 18X90

Facility

$1,805.76

Service Code	HCPCS C1876
Hospital Charge Code	41540618
Hospital Revenue Code	278
Min. Negotiated Rate	$902.88
Max. Negotiated Rate	$902.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$902.88
Rate for Payer: Hamaspik Choice Inc Medicare	$902.88

ZZ BS WALLSTENT ENDOPROSTHESIS

Facility

$1,182.72

Hospital Charge Code	41540612
Hospital Revenue Code	272
Min. Negotiated Rate	$413.95
Max. Negotiated Rate	$946.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$650.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$591.36
Rate for Payer: Aetna Government	$591.36
Rate for Payer: Brighton Health Commercial	$887.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$946.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$804.25
Rate for Payer: Group Health Inc Commercial	$591.36
Rate for Payer: Group Health Inc Medicare	$413.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$591.36
Rate for Payer: Hamaspik Choice Inc Medicare	$591.36

ZZ CARDIVA BOOMERANG CLOSURE WIRE

Facility

$3,000.00

Hospital Charge Code	41569913
Hospital Revenue Code	270
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,500.00
Rate for Payer: Aetna Government	$1,500.00
Rate for Payer: Brighton Health Commercial	$2,250.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,040.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

ZZ CASSI II BIOPSY DEVI/SYS

Facility

$490.00

Hospital Charge Code	41569957
Hospital Revenue Code	279
Min. Negotiated Rate	$171.50
Max. Negotiated Rate	$392.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$269.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$245.00
Rate for Payer: Aetna Government	$245.00
Rate for Payer: Brighton Health Commercial	$367.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$392.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$333.20
Rate for Payer: Group Health Inc Commercial	$245.00
Rate for Payer: Group Health Inc Medicare	$171.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00

ZZ CAT8 TORQ 85CM 8F

Facility

$5,980.00

Hospital Charge Code	41563142
Hospital Revenue Code	272
Min. Negotiated Rate	$2,093.00
Max. Negotiated Rate	$4,784.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,289.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,990.00
Rate for Payer: Aetna Government	$2,990.00
Rate for Payer: Brighton Health Commercial	$4,485.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,784.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,066.40
Rate for Payer: Group Health Inc Commercial	$2,990.00
Rate for Payer: Group Health Inc Medicare	$2,093.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,990.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,990.00

ZZ CATH 1H 4 FR 035-100

Facility

$46.78

Service Code	HCPCS C1725
Hospital Charge Code	41569697
Hospital Revenue Code	278
Min. Negotiated Rate	$16.37
Max. Negotiated Rate	$49.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$28.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.90
Rate for Payer: EmblemHealth Commercial	$23.39
Rate for Payer: Fidelis Medicare Advantage	$49.12
Rate for Payer: Group Health Inc Commercial	$23.39
Rate for Payer: Group Health Inc Medicare	$16.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.39
Rate for Payer: Hamaspik Choice Inc Medicare	$23.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$30.41

ZZ CATH 1H 4 FR 035-100

Facility

$46.78

Service Code	HCPCS C1725
Hospital Charge Code	41569697
Hospital Revenue Code	278
Min. Negotiated Rate	$23.39
Max. Negotiated Rate	$23.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.39
Rate for Payer: Hamaspik Choice Inc Medicare	$23.39

ZZ CATH/65/CI/SUPPER TORQUE

Facility

$32.96

Service Code	HCPCS C1725
Hospital Charge Code	41569377
Hospital Revenue Code	278
Min. Negotiated Rate	$11.54
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$19.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.95
Rate for Payer: EmblemHealth Commercial	$16.48
Rate for Payer: Fidelis Medicare Advantage	$34.61
Rate for Payer: Group Health Inc Commercial	$16.48
Rate for Payer: Group Health Inc Medicare	$11.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.48
Rate for Payer: Hamaspik Choice Inc Medicare	$16.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.42

ZZ CATH/65/CI/SUPPER TORQUE

Facility

$32.96

Service Code	HCPCS C1725
Hospital Charge Code	41569377
Hospital Revenue Code	278
Min. Negotiated Rate	$16.48
Max. Negotiated Rate	$16.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.48
Rate for Payer: Hamaspik Choice Inc Medicare	$16.48

ZZ CATH/6F/PIG/90CM/1200PSI

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569379
Hospital Revenue Code	278
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$19.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.58
Rate for Payer: EmblemHealth Commercial	$16.16
Rate for Payer: Fidelis Medicare Advantage	$33.94
Rate for Payer: Group Health Inc Commercial	$16.16
Rate for Payer: Group Health Inc Medicare	$11.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.01

ZZ CATH/6F/PIG/90CM/1200PSI

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569379
Hospital Revenue Code	278
Min. Negotiated Rate	$16.16
Max. Negotiated Rate	$16.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16

ZZ CATH/COBRA1/4F/.035/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569380
Hospital Revenue Code	278
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$19.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.58
Rate for Payer: EmblemHealth Commercial	$16.16
Rate for Payer: Fidelis Medicare Advantage	$33.94
Rate for Payer: Group Health Inc Commercial	$16.16
Rate for Payer: Group Health Inc Medicare	$11.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.01

ZZ CATH/COBRA1/4F/.035/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569380
Hospital Revenue Code	278
Min. Negotiated Rate	$16.16
Max. Negotiated Rate	$16.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16

ZZ CATH/COBRA1/5F/.035/100CM

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569381
Hospital Revenue Code	278
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.60
Rate for Payer: Hamaspik Choice Inc Medicare	$18.60

ZZ CATH/COBRA1/5F/.035/100CM

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569381
Hospital Revenue Code	278
Min. Negotiated Rate	$13.02
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$22.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.40
Rate for Payer: EmblemHealth Commercial	$18.60
Rate for Payer: Fidelis Medicare Advantage	$39.07
Rate for Payer: Group Health Inc Commercial	$18.60
Rate for Payer: Group Health Inc Medicare	$13.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.60
Rate for Payer: Hamaspik Choice Inc Medicare	$18.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$24.19

ZZ CATH/COBRA1/5F/.035/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569382
Hospital Revenue Code	278
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$19.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.58
Rate for Payer: EmblemHealth Commercial	$16.16
Rate for Payer: Fidelis Medicare Advantage	$33.94
Rate for Payer: Group Health Inc Commercial	$16.16
Rate for Payer: Group Health Inc Medicare	$11.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.01

ZZ CATH/COBRA1/5F/.035/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569382
Hospital Revenue Code	278
Min. Negotiated Rate	$16.16
Max. Negotiated Rate	$16.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.16
Rate for Payer: Hamaspik Choice Inc Medicare	$16.16

ZZ CATH COBRA 1 5FR 035-90CM

Facility

$56.00

Service Code	HCPCS C1725
Hospital Charge Code	41569730
Hospital Revenue Code	278
Min. Negotiated Rate	$19.60
Max. Negotiated Rate	$58.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$33.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.20
Rate for Payer: EmblemHealth Commercial	$28.00
Rate for Payer: Fidelis Medicare Advantage	$58.80
Rate for Payer: Group Health Inc Commercial	$28.00
Rate for Payer: Group Health Inc Medicare	$19.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.00
Rate for Payer: Hamaspik Choice Inc Medicare	$28.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.40

Know your out-of-pocket cost for care.

All Charges