St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ CLASS BALL 5-4/4.8/120

Facility

$635.75

Hospital Charge Code	41567266
Hospital Revenue Code	270
Min. Negotiated Rate	$222.51
Max. Negotiated Rate	$508.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$349.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$317.88
Rate for Payer: Aetna Government	$317.88
Rate for Payer: Brighton Health Commercial	$476.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$508.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$432.31
Rate for Payer: Group Health Inc Commercial	$317.88
Rate for Payer: Group Health Inc Medicare	$222.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$317.88
Rate for Payer: Hamaspik Choice Inc Medicare	$317.88

ZZ CLASS BALL 6-4/4.8/75

Facility

$586.85

Hospital Charge Code	41567265
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Brighton Health Commercial	$440.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BALL 7-2.5/5/75

Facility

$586.85

Hospital Charge Code	41567262
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Brighton Health Commercial	$440.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BALL 7-4/5/75

Facility

$586.85

Hospital Charge Code	41567263
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Brighton Health Commercial	$440.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BALL 8-4/5/75

Facility

$586.85

Hospital Charge Code	41567261
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Brighton Health Commercial	$440.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BL 5-2.5/4.8/75

Facility

$586.85

Hospital Charge Code	41567267
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Brighton Health Commercial	$440.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CLASS BL 8-2.5/5/75

Facility

$586.85

Hospital Charge Code	41567260
Hospital Revenue Code	270
Min. Negotiated Rate	$205.40
Max. Negotiated Rate	$469.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$293.42
Rate for Payer: Aetna Government	$293.42
Rate for Payer: Brighton Health Commercial	$440.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.06
Rate for Payer: Group Health Inc Commercial	$293.42
Rate for Payer: Group Health Inc Medicare	$205.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.42
Rate for Payer: Hamaspik Choice Inc Medicare	$293.42

ZZ CNCT TUB END 14 30 ST

Facility

$25.16

Hospital Charge Code	41567293
Hospital Revenue Code	270
Min. Negotiated Rate	$8.81
Max. Negotiated Rate	$20.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.58
Rate for Payer: Aetna Government	$12.58
Rate for Payer: Brighton Health Commercial	$18.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.11
Rate for Payer: Group Health Inc Commercial	$12.58
Rate for Payer: Group Health Inc Medicare	$8.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.58
Rate for Payer: Hamaspik Choice Inc Medicare	$12.58

ZZ COAX QK CR NDL 20 9 20

Facility

$120.49

Hospital Charge Code	41567084
Hospital Revenue Code	270
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$96.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.24
Rate for Payer: Aetna Government	$60.24
Rate for Payer: Brighton Health Commercial	$90.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$96.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.93
Rate for Payer: Group Health Inc Commercial	$60.24
Rate for Payer: Group Health Inc Medicare	$42.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.24
Rate for Payer: Hamaspik Choice Inc Medicare	$60.24

ZZ COBRA (2) 4 65

Facility

$48.91

Hospital Charge Code	41567160
Hospital Revenue Code	270
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$39.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.46
Rate for Payer: Aetna Government	$24.46
Rate for Payer: Brighton Health Commercial	$36.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.26
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

ZZ COBRA (2) 5 65

Facility

$48.91

Hospital Charge Code	41567161
Hospital Revenue Code	270
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$39.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.46
Rate for Payer: Aetna Government	$24.46
Rate for Payer: Brighton Health Commercial	$36.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.26
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

ZZ COBRA 4.1FRX100 CATHETER

Facility

$55.00

Hospital Charge Code	41567744
Hospital Revenue Code	270
Min. Negotiated Rate	$19.25
Max. Negotiated Rate	$44.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.50
Rate for Payer: Aetna Government	$27.50
Rate for Payer: Brighton Health Commercial	$41.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.40
Rate for Payer: Group Health Inc Commercial	$27.50
Rate for Payer: Group Health Inc Medicare	$19.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.50
Rate for Payer: Hamaspik Choice Inc Medicare	$27.50

ZZ COIL/.018 HILAL

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41560050
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41560050
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$76.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: EmblemHealth Commercial	$63.94
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/1.5-5

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569045
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$76.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: EmblemHealth Commercial	$63.94
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/1.5-5

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569045
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/2-1-7

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569048
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$76.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: EmblemHealth Commercial	$63.94
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/2-1-7

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569048
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/2-2

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569046
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/2-2

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569046
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$76.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: EmblemHealth Commercial	$63.94
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/2-4

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569047
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/2-4

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569047
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$76.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: EmblemHealth Commercial	$63.94
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/3-10

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569049
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$76.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: EmblemHealth Commercial	$63.94
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

ZZ COIL/.018 HILAL/3-10

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569049
Hospital Revenue Code	278
Min. Negotiated Rate	$63.94
Max. Negotiated Rate	$63.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94

ZZ COIL/.018 HILAL/3-4

Facility

$127.87

Service Code	HCPCS C1884
Hospital Charge Code	41569050
Hospital Revenue Code	278
Min. Negotiated Rate	$44.75
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$76.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.53
Rate for Payer: EmblemHealth Commercial	$63.94
Rate for Payer: Fidelis Medicare Advantage	$134.26
Rate for Payer: Group Health Inc Commercial	$63.94
Rate for Payer: Group Health Inc Medicare	$44.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.94
Rate for Payer: Hamaspik Choice Inc Medicare	$63.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.12

Know your out-of-pocket cost for care.

All Charges