St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$28.00
Max. Negotiated Rate	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.00
Rate for Payer: Hamaspik Choice Inc Medicare	$28.00

ZZ CATH COBRA 1 PEDS 5FR 035-65CM

Facility

$24.10

Service Code	HCPCS C1725
Hospital Charge Code	41569731
Hospital Revenue Code	278
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$14.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.86
Rate for Payer: EmblemHealth Commercial	$12.05
Rate for Payer: Fidelis Medicare Advantage	$25.30
Rate for Payer: Group Health Inc Commercial	$12.05
Rate for Payer: Group Health Inc Medicare	$8.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.05
Rate for Payer: Hamaspik Choice Inc Medicare	$12.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.66

ZZ CATH COBRA 1 PEDS 5FR 035-65CM

Facility

$24.10

Service Code	HCPCS C1725
Hospital Charge Code	41569731
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$12.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.05
Rate for Payer: Hamaspik Choice Inc Medicare	$12.05

ZZ CATH COBRA1 SELECT 5FR 035-65

Facility

$50.89

Service Code	HCPCS C1725
Hospital Charge Code	41569707
Hospital Revenue Code	278
Min. Negotiated Rate	$25.44
Max. Negotiated Rate	$25.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.44
Rate for Payer: Hamaspik Choice Inc Medicare	$25.44

ZZ CATH COBRA1 SELECT 5FR 035-65

Facility

$50.89

Service Code	HCPCS C1725
Hospital Charge Code	41569707
Hospital Revenue Code	278
Min. Negotiated Rate	$17.81
Max. Negotiated Rate	$53.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$30.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.26
Rate for Payer: EmblemHealth Commercial	$25.44
Rate for Payer: Fidelis Medicare Advantage	$53.43
Rate for Payer: Group Health Inc Commercial	$25.44
Rate for Payer: Group Health Inc Medicare	$17.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.44
Rate for Payer: Hamaspik Choice Inc Medicare	$25.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.08

ZZ CATH/COBRA2/4F/.035/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569383
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/COBRA2/4F/.035/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569383
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/COBRA2/5F/.035

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569384
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/COBRA2/5F/.035

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569384
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/COBRA2/5F/.035/100CM

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569385
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/COBRA2/5F/.035/100CM

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569385
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 COBRA 3 5FR 038-90

Facility

$226.80

Service Code	HCPCS C1725
Hospital Charge Code	41569706
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$113.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.40
Rate for Payer: Hamaspik Choice Inc Medicare	$113.40

ZZ CATH COBRA 3 5FR 038-90

Facility

$226.80

Service Code	HCPCS C1725
Hospital Charge Code	41569706
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$238.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$124.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$136.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$113.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$130.41
Rate for Payer: EmblemHealth Commercial	$113.40
Rate for Payer: Fidelis Medicare Advantage	$238.14
Rate for Payer: Group Health Inc Commercial	$113.40
Rate for Payer: Group Health Inc Medicare	$79.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.40
Rate for Payer: Hamaspik Choice Inc Medicare	$113.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$147.42

ZZ CATH/CRAIG INFUSION/4FR

Facility

$299.38

Service Code	HCPCS C1725
Hospital Charge Code	41569740
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$314.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$164.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$179.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$149.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.14
Rate for Payer: EmblemHealth Commercial	$149.69
Rate for Payer: Fidelis Medicare Advantage	$314.35
Rate for Payer: Group Health Inc Commercial	$149.69
Rate for Payer: Group Health Inc Medicare	$104.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$149.69
Rate for Payer: Hamaspik Choice Inc Medicare	$149.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$194.60

ZZ CATH/CRAIG INFUSION/4FR

Facility

$299.38

Service Code	HCPCS C1725
Hospital Charge Code	41569740
Hospital Revenue Code	278
Min. Negotiated Rate	$149.69
Max. Negotiated Rate	$149.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$149.69
Rate for Payer: Hamaspik Choice Inc Medicare	$149.69

ZZ CATH/CRAIG INFUSION/5FR

Facility

$267.91

Service Code	HCPCS C1725
Hospital Charge Code	41569739
Hospital Revenue Code	278
Min. Negotiated Rate	$133.96
Max. Negotiated Rate	$133.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.96
Rate for Payer: Hamaspik Choice Inc Medicare	$133.96

ZZ CATH/CRAIG INFUSION/5FR

Facility

$267.91

Service Code	HCPCS C1725
Hospital Charge Code	41569739
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$281.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$147.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$160.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$154.05
Rate for Payer: EmblemHealth Commercial	$133.96
Rate for Payer: Fidelis Medicare Advantage	$281.31
Rate for Payer: Group Health Inc Commercial	$133.96
Rate for Payer: Group Health Inc Medicare	$93.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.96
Rate for Payer: Hamaspik Choice Inc Medicare	$133.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$174.14

ZZ CATH/DRAINAGE/BIL/10.2/32

Facility

$203.60

Service Code	HCPCS C1725
Hospital Charge Code	41569376
Hospital Revenue Code	278
Min. Negotiated Rate	$101.80
Max. Negotiated Rate	$101.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$101.80
Rate for Payer: Hamaspik Choice Inc Medicare	$101.80

ZZ CATH/DRAINAGE/BIL/10.2/32

Facility

$203.60

Service Code	HCPCS C1725
Hospital Charge Code	41569376
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$213.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$111.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$122.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$101.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$117.07
Rate for Payer: EmblemHealth Commercial	$101.80
Rate for Payer: Fidelis Medicare Advantage	$213.78
Rate for Payer: Group Health Inc Commercial	$101.80
Rate for Payer: Group Health Inc Medicare	$71.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$101.80
Rate for Payer: Hamaspik Choice Inc Medicare	$101.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$132.34

ZZ CATHETER 5 18 5 MP

Facility

$75.84

Service Code	HCPCS C1725
Hospital Charge Code	41567194
Hospital Revenue Code	278
Min. Negotiated Rate	$37.92
Max. Negotiated Rate	$37.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.92
Rate for Payer: Hamaspik Choice Inc Medicare	$37.92

ZZ CATHETER 5 18 5 MP

Facility

$75.84

Service Code	HCPCS C1725
Hospital Charge Code	41567194
Hospital Revenue Code	278
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$79.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$45.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.61
Rate for Payer: EmblemHealth Commercial	$37.92
Rate for Payer: Fidelis Medicare Advantage	$79.63
Rate for Payer: Group Health Inc Commercial	$37.92
Rate for Payer: Group Health Inc Medicare	$26.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.92
Rate for Payer: Hamaspik Choice Inc Medicare	$37.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$49.30

ZZ CATHETER 8/25

Facility

$257.63

Service Code	HCPCS C1725
Hospital Charge Code	41567230
Hospital Revenue Code	278
Min. Negotiated Rate	$128.82
Max. Negotiated Rate	$128.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.82
Rate for Payer: Hamaspik Choice Inc Medicare	$128.82

ZZ CATHETER 8/25

Facility

$257.63

Service Code	HCPCS C1725
Hospital Charge Code	41567230
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$270.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$141.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$154.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$148.14
Rate for Payer: EmblemHealth Commercial	$128.82
Rate for Payer: Fidelis Medicare Advantage	$270.51
Rate for Payer: Group Health Inc Commercial	$128.82
Rate for Payer: Group Health Inc Medicare	$90.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.82
Rate for Payer: Hamaspik Choice Inc Medicare	$128.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$167.46

ZZ CATHGLIDE 5FR100CM

Facility

$136.73

Service Code	HCPCS C1725
Hospital Charge Code	41569664
Hospital Revenue Code	278
Min. Negotiated Rate	$68.36
Max. Negotiated Rate	$68.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.36
Rate for Payer: Hamaspik Choice Inc Medicare	$68.36

ZZ CATHGLIDE 5FR100CM

Facility

$136.73

Service Code	HCPCS C1725
Hospital Charge Code	41569664
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$143.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$75.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$82.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$68.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.62
Rate for Payer: EmblemHealth Commercial	$68.36
Rate for Payer: Fidelis Medicare Advantage	$143.57
Rate for Payer: Group Health Inc Commercial	$68.36
Rate for Payer: Group Health Inc Medicare	$47.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.36
Rate for Payer: Hamaspik Choice Inc Medicare	$68.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$88.87

Know your out-of-pocket cost for care.

All Charges