St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ CATH/HIH/6.5F/.035/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569400
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/HIH/6.5F/.035/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569400
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/HOPKINS EMBOLECTOMY

Facility

$39.33

Service Code	HCPCS C1725
Hospital Charge Code	41569401
Hospital Revenue Code	278
Min. Negotiated Rate	$19.66
Max. Negotiated Rate	$19.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.66
Rate for Payer: Hamaspik Choice Inc Medicare	$19.66

ZZ CATH/HOPKINS EMBOLECTOMY

Facility

$39.33

Service Code	HCPCS C1725
Hospital Charge Code	41569401
Hospital Revenue Code	278
Min. Negotiated Rate	$13.77
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$23.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.61
Rate for Payer: EmblemHealth Commercial	$19.66
Rate for Payer: Fidelis Medicare Advantage	$41.30
Rate for Payer: Group Health Inc Commercial	$19.66
Rate for Payer: Group Health Inc Medicare	$13.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.66
Rate for Payer: Hamaspik Choice Inc Medicare	$19.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$25.56

ZZ CATH INT N3 B NT 100

Facility

$114.11

Service Code	HCPCS C1725
Hospital Charge Code	41567185
Hospital Revenue Code	278
Min. Negotiated Rate	$57.06
Max. Negotiated Rate	$57.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.06
Rate for Payer: Hamaspik Choice Inc Medicare	$57.06

ZZ CATH INT N3 B NT 100

Facility

$114.11

Service Code	HCPCS C1725
Hospital Charge Code	41567185
Hospital Revenue Code	278
Min. Negotiated Rate	$39.94
Max. Negotiated Rate	$119.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$68.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.61
Rate for Payer: EmblemHealth Commercial	$57.06
Rate for Payer: Fidelis Medicare Advantage	$119.82
Rate for Payer: Group Health Inc Commercial	$57.06
Rate for Payer: Group Health Inc Medicare	$39.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.06
Rate for Payer: Hamaspik Choice Inc Medicare	$57.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$74.17

ZZ CATH INT N3 B NT 80

Facility

$114.11

Service Code	HCPCS C1725
Hospital Charge Code	41567186
Hospital Revenue Code	278
Min. Negotiated Rate	$57.06
Max. Negotiated Rate	$57.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.06
Rate for Payer: Hamaspik Choice Inc Medicare	$57.06

ZZ CATH INT N3 B NT 80

Facility

$114.11

Service Code	HCPCS C1725
Hospital Charge Code	41567186
Hospital Revenue Code	278
Min. Negotiated Rate	$39.94
Max. Negotiated Rate	$119.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$68.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.61
Rate for Payer: EmblemHealth Commercial	$57.06
Rate for Payer: Fidelis Medicare Advantage	$119.82
Rate for Payer: Group Health Inc Commercial	$57.06
Rate for Payer: Group Health Inc Medicare	$39.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.06
Rate for Payer: Hamaspik Choice Inc Medicare	$57.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$74.17

ZZ CATH/KUMPER/5.5/.038/40CM

Facility

$32.32

Hospital Charge Code	41569402
Hospital Revenue Code	270
Min. Negotiated Rate	$11.31
Max. Negotiated Rate	$25.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.16
Rate for Payer: Aetna Government	$16.16
Rate for Payer: Brighton Health Commercial	$24.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.98
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

ZZ CATH/LEVIN1/5F/.038/100CM

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569406
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/LEVIN1/5F/.038/100CM

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569406
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/LEVIN1/6.5F/.038/65C

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569346
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/LEVIN1/6.5F/.038/65C

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569346
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/LEVIN2/5F/.038/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569403
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/LEVIN2/5F/.038/65CM

Facility

$32.32

Service Code	HCPCS C1725
Hospital Charge Code	41569403
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/LEVIN2/6.5F

Facility

$36.61

Service Code	HCPCS C1725
Hospital Charge Code	41569404
Hospital Revenue Code	278
Min. Negotiated Rate	$12.81
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$21.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.05
Rate for Payer: EmblemHealth Commercial	$18.30
Rate for Payer: Fidelis Medicare Advantage	$38.44
Rate for Payer: Group Health Inc Commercial	$18.30
Rate for Payer: Group Health Inc Medicare	$12.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.30
Rate for Payer: Hamaspik Choice Inc Medicare	$18.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23.80

ZZ CATH/LEVIN2/6.5F

Facility

$36.61

Service Code	HCPCS C1725
Hospital Charge Code	41569404
Hospital Revenue Code	278
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.30
Rate for Payer: Hamaspik Choice Inc Medicare	$18.30

ZZ CATH/LEVIN/6F/65CM

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569405
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/LEVIN/6F/65CM

Facility

$37.21

Service Code	HCPCS C1725
Hospital Charge Code	41569405
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 LEVIN VISCERAL 5FR 038-65

Facility

$56.00

Service Code	HCPCS C1725
Hospital Charge Code	41569704
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 LEVIN VISCERAL 5FR 038-65

Facility

$56.00

Service Code	HCPCS C1725
Hospital Charge Code	41569704
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

ZZ CATH MULTIPURP. I 4FR 035-100

Facility

$3.19

Service Code	HCPCS C1725
Hospital Charge Code	41569705
Hospital Revenue Code	278
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$1.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.83
Rate for Payer: EmblemHealth Commercial	$1.60
Rate for Payer: Fidelis Medicare Advantage	$3.35
Rate for Payer: Group Health Inc Commercial	$1.60
Rate for Payer: Group Health Inc Medicare	$1.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.07

ZZ CATH MULTIPURP. I 4FR 035-100

Facility

$3.19

Service Code	HCPCS C1725
Hospital Charge Code	41569705
Hospital Revenue Code	278
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$1.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1.60

ZZ CATH/MULTIPURPOSE/4F/.035

Facility

$35.08

Service Code	HCPCS C1725
Hospital Charge Code	41569347
Hospital Revenue Code	278
Min. Negotiated Rate	$17.54
Max. Negotiated Rate	$17.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.54
Rate for Payer: Hamaspik Choice Inc Medicare	$17.54

ZZ CATH/MULTIPURPOSE/4F/.035

Facility

$35.08

Service Code	HCPCS C1725
Hospital Charge Code	41569347
Hospital Revenue Code	278
Min. Negotiated Rate	$12.28
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$21.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.17
Rate for Payer: EmblemHealth Commercial	$17.54
Rate for Payer: Fidelis Medicare Advantage	$36.83
Rate for Payer: Group Health Inc Commercial	$17.54
Rate for Payer: Group Health Inc Medicare	$12.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.54
Rate for Payer: Hamaspik Choice Inc Medicare	$17.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.80

Know your out-of-pocket cost for care.

All Charges