St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ COIL/.052 STANDARD/15-20

Facility

$92.82

Service Code	HCPCS C1884
Hospital Charge Code	41569285
Hospital Revenue Code	278
Min. Negotiated Rate	$46.41
Max. Negotiated Rate	$46.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$46.41
Rate for Payer: Hamaspik Choice Inc Medicare	$46.41

ZZ COIL/.052 STANDARD/15-20

Facility

$92.82

Service Code	HCPCS C1884
Hospital Charge Code	41569285
Hospital Revenue Code	278
Min. Negotiated Rate	$32.49
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$55.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$53.37
Rate for Payer: EmblemHealth Commercial	$46.41
Rate for Payer: Fidelis Medicare Advantage	$97.46
Rate for Payer: Group Health Inc Commercial	$46.41
Rate for Payer: Group Health Inc Medicare	$32.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$46.41
Rate for Payer: Hamaspik Choice Inc Medicare	$46.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$60.33

ZZ COIL/DETACHABLE COIL GUIDE/35

Facility

$162.94

Service Code	HCPCS C1884
Hospital Charge Code	41569292
Hospital Revenue Code	278
Min. Negotiated Rate	$57.03
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$97.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.69
Rate for Payer: EmblemHealth Commercial	$81.47
Rate for Payer: Fidelis Medicare Advantage	$171.09
Rate for Payer: Group Health Inc Commercial	$81.47
Rate for Payer: Group Health Inc Medicare	$57.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.47
Rate for Payer: Hamaspik Choice Inc Medicare	$81.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.91

ZZ COIL/DETACHABLE COIL GUIDE/35

Facility

$162.94

Service Code	HCPCS C1884
Hospital Charge Code	41569292
Hospital Revenue Code	278
Min. Negotiated Rate	$81.47
Max. Negotiated Rate	$81.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.47
Rate for Payer: Hamaspik Choice Inc Medicare	$81.47

ZZ COIL PUSHER

Facility

$309.73

Service Code	HCPCS C1884
Hospital Charge Code	41560058
Hospital Revenue Code	278
Min. Negotiated Rate	$108.41
Max. Negotiated Rate	$325.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$170.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$185.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$154.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$178.09
Rate for Payer: EmblemHealth Commercial	$154.86
Rate for Payer: Fidelis Medicare Advantage	$325.22
Rate for Payer: Group Health Inc Commercial	$154.86
Rate for Payer: Group Health Inc Medicare	$108.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.86
Rate for Payer: Hamaspik Choice Inc Medicare	$154.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$201.32

ZZ COIL PUSHER

Facility

$309.73

Service Code	HCPCS C1884
Hospital Charge Code	41560058
Hospital Revenue Code	278
Min. Negotiated Rate	$154.86
Max. Negotiated Rate	$154.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.86
Rate for Payer: Hamaspik Choice Inc Medicare	$154.86

ZZ COIL PUSHER 16

Facility

$309.73

Service Code	HCPCS C1884
Hospital Charge Code	41567159
Hospital Revenue Code	278
Min. Negotiated Rate	$154.86
Max. Negotiated Rate	$154.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.86
Rate for Payer: Hamaspik Choice Inc Medicare	$154.86

ZZ COIL PUSHER 16

Facility

$309.73

Service Code	HCPCS C1884
Hospital Charge Code	41567159
Hospital Revenue Code	278
Min. Negotiated Rate	$108.41
Max. Negotiated Rate	$325.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$170.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$185.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$154.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$178.09
Rate for Payer: EmblemHealth Commercial	$154.86
Rate for Payer: Fidelis Medicare Advantage	$325.22
Rate for Payer: Group Health Inc Commercial	$154.86
Rate for Payer: Group Health Inc Medicare	$108.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.86
Rate for Payer: Hamaspik Choice Inc Medicare	$154.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$201.32

ZZ COLAP TRANSJUG CHOLANG

Facility

$733.56

Hospital Charge Code	41567320
Hospital Revenue Code	270
Min. Negotiated Rate	$256.75
Max. Negotiated Rate	$586.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$403.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$366.78
Rate for Payer: Aetna Government	$366.78
Rate for Payer: Brighton Health Commercial	$550.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$586.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$498.82
Rate for Payer: Group Health Inc Commercial	$366.78
Rate for Payer: Group Health Inc Medicare	$256.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$366.78
Rate for Payer: Hamaspik Choice Inc Medicare	$366.78

ZZ CONNECTING TUBE/DRAINAGE/YTYPE

Facility

$24.54

Hospital Charge Code	41569293
Hospital Revenue Code	270
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$19.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.27
Rate for Payer: Aetna Government	$12.27
Rate for Payer: Brighton Health Commercial	$18.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.69
Rate for Payer: Group Health Inc Commercial	$12.27
Rate for Payer: Group Health Inc Medicare	$8.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.27
Rate for Payer: Hamaspik Choice Inc Medicare	$12.27

ZZ CONNECTOR/FEMALE FOLEY

Facility

$8.88

Hospital Charge Code	41569297
Hospital Revenue Code	270
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$7.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.44
Rate for Payer: Aetna Government	$4.44
Rate for Payer: Brighton Health Commercial	$6.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.04
Rate for Payer: Group Health Inc Commercial	$4.44
Rate for Payer: Group Health Inc Medicare	$3.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.44
Rate for Payer: Hamaspik Choice Inc Medicare	$4.44

ZZ CONNECTOR/MALE FOLEY

Facility

$8.79

Hospital Charge Code	41569298
Hospital Revenue Code	270
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$7.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.40
Rate for Payer: Aetna Government	$4.40
Rate for Payer: Brighton Health Commercial	$6.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.98
Rate for Payer: Group Health Inc Commercial	$4.40
Rate for Payer: Group Health Inc Medicare	$3.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.40
Rate for Payer: Hamaspik Choice Inc Medicare	$4.40

ZZ CONNECTOR/ MALE LUER LOCK

Facility

$7.06

Hospital Charge Code	41569299
Hospital Revenue Code	270
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$5.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.53
Rate for Payer: Aetna Government	$3.53
Rate for Payer: Brighton Health Commercial	$5.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.80
Rate for Payer: Group Health Inc Commercial	$3.53
Rate for Payer: Group Health Inc Medicare	$2.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.53
Rate for Payer: Hamaspik Choice Inc Medicare	$3.53

ZZ CONNECTOR TUBE/DRAINAGE/STTYPE

Facility

$21.13

Hospital Charge Code	41569294
Hospital Revenue Code	270
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$16.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.56
Rate for Payer: Aetna Government	$10.56
Rate for Payer: Brighton Health Commercial	$15.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.37
Rate for Payer: Group Health Inc Commercial	$10.56
Rate for Payer: Group Health Inc Medicare	$7.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.56
Rate for Payer: Hamaspik Choice Inc Medicare	$10.56

ZZ CONNECTOR TUBE/HIGH/PRESSURE

Facility

$22.19

Hospital Charge Code	41569295
Hospital Revenue Code	270
Min. Negotiated Rate	$7.77
Max. Negotiated Rate	$17.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.10
Rate for Payer: Aetna Government	$11.10
Rate for Payer: Brighton Health Commercial	$16.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.09
Rate for Payer: Group Health Inc Commercial	$11.10
Rate for Payer: Group Health Inc Medicare	$7.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.10
Rate for Payer: Hamaspik Choice Inc Medicare	$11.10

ZZ CONQUEST BALL 10/4/75

Facility

$722.93

Service Code	HCPCS C1725
Hospital Charge Code	41569772
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$759.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$397.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$433.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$361.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$415.68
Rate for Payer: EmblemHealth Commercial	$361.46
Rate for Payer: Fidelis Medicare Advantage	$759.08
Rate for Payer: Group Health Inc Commercial	$361.46
Rate for Payer: Group Health Inc Medicare	$253.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$361.46
Rate for Payer: Hamaspik Choice Inc Medicare	$361.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$469.90

ZZ CONQUEST BALL 10/4/75

Facility

$722.93

Service Code	HCPCS C1725
Hospital Charge Code	41569772
Hospital Revenue Code	278
Min. Negotiated Rate	$361.46
Max. Negotiated Rate	$361.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$361.46
Rate for Payer: Hamaspik Choice Inc Medicare	$361.46

ZZ CONQUEST BALL 12/4/75

Facility

$1,909.65

Hospital Charge Code	41569773
Hospital Revenue Code	279
Min. Negotiated Rate	$668.38
Max. Negotiated Rate	$1,527.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,050.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$954.82
Rate for Payer: Aetna Government	$954.82
Rate for Payer: Brighton Health Commercial	$1,432.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,527.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,298.56
Rate for Payer: Group Health Inc Commercial	$954.82
Rate for Payer: Group Health Inc Medicare	$668.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.82
Rate for Payer: Hamaspik Choice Inc Medicare	$954.82

ZZ CONQUEST BALL 8/4/75

Facility

$722.93

Service Code	HCPCS C1725
Hospital Charge Code	41569771
Hospital Revenue Code	278
Min. Negotiated Rate	$361.46
Max. Negotiated Rate	$361.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$361.46
Rate for Payer: Hamaspik Choice Inc Medicare	$361.46

ZZ CONQUEST BALL 8/4/75

Facility

$722.93

Service Code	HCPCS C1725
Hospital Charge Code	41569771
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$759.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$397.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$433.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$361.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$415.68
Rate for Payer: EmblemHealth Commercial	$361.46
Rate for Payer: Fidelis Medicare Advantage	$759.08
Rate for Payer: Group Health Inc Commercial	$361.46
Rate for Payer: Group Health Inc Medicare	$253.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$361.46
Rate for Payer: Hamaspik Choice Inc Medicare	$361.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$469.90

ZZ CONTOUR EMBOLI 250-355

Facility

$277.13

Service Code	HCPCS C1884
Hospital Charge Code	41567347
Hospital Revenue Code	278
Min. Negotiated Rate	$138.56
Max. Negotiated Rate	$138.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.56
Rate for Payer: Hamaspik Choice Inc Medicare	$138.56

ZZ CONTOUR EMBOLI 250-355

Facility

$277.13

Service Code	HCPCS C1884
Hospital Charge Code	41567347
Hospital Revenue Code	278
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$290.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$166.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$138.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.35
Rate for Payer: EmblemHealth Commercial	$138.56
Rate for Payer: Fidelis Medicare Advantage	$290.99
Rate for Payer: Group Health Inc Commercial	$138.56
Rate for Payer: Group Health Inc Medicare	$97.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.56
Rate for Payer: Hamaspik Choice Inc Medicare	$138.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.13

ZZ CONTOUR EMBOLI 355-500

Facility

$277.13

Hospital Charge Code	41567348
Hospital Revenue Code	270
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$221.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$138.56
Rate for Payer: Aetna Government	$138.56
Rate for Payer: Brighton Health Commercial	$207.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$221.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.45
Rate for Payer: Group Health Inc Commercial	$138.56
Rate for Payer: Group Health Inc Medicare	$97.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.56
Rate for Payer: Hamaspik Choice Inc Medicare	$138.56

ZZ CONTOUR EMBOLI 500-710

Facility

$277.13

Hospital Charge Code	41567349
Hospital Revenue Code	270
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$221.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$138.56
Rate for Payer: Aetna Government	$138.56
Rate for Payer: Brighton Health Commercial	$207.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$221.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.45
Rate for Payer: Group Health Inc Commercial	$138.56
Rate for Payer: Group Health Inc Medicare	$97.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.56
Rate for Payer: Hamaspik Choice Inc Medicare	$138.56

ZZ CONTRA FLUSH II 5FR 035-65

Facility

$50.89

Service Code	HCPCS C1725
Hospital Charge Code	41569699
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

Know your out-of-pocket cost for care.

All Charges