St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$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 CONTRAST CONT SPK ASS

Facility

$9.92

Hospital Charge Code	41567003
Hospital Revenue Code	270
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$7.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.96
Rate for Payer: Aetna Government	$4.96
Rate for Payer: Brighton Health Commercial	$7.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.75
Rate for Payer: Group Health Inc Commercial	$4.96
Rate for Payer: Group Health Inc Medicare	$3.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.96
Rate for Payer: Hamaspik Choice Inc Medicare	$4.96

ZZ COOK 1 WAY STOPCOCK

Facility

$6.32

Hospital Charge Code	41569605
Hospital Revenue Code	270
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$5.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.16
Rate for Payer: Aetna Government	$3.16
Rate for Payer: Brighton Health Commercial	$4.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.30
Rate for Payer: Group Health Inc Commercial	$3.16
Rate for Payer: Group Health Inc Medicare	$2.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.16
Rate for Payer: Hamaspik Choice Inc Medicare	$3.16

ZZ COOK 7 FRENCH PEELAWAY INT SET

Facility

$99.75

Hospital Charge Code	41569833
Hospital Revenue Code	270
Min. Negotiated Rate	$34.91
Max. Negotiated Rate	$79.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$54.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$49.88
Rate for Payer: Aetna Government	$49.88
Rate for Payer: Brighton Health Commercial	$74.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.83
Rate for Payer: Group Health Inc Commercial	$49.88
Rate for Payer: Group Health Inc Medicare	$34.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.88
Rate for Payer: Hamaspik Choice Inc Medicare	$49.88

ZZ COOK BALLOON DILA/CATH5MMX10CM

Facility

$420.00

Service Code	HCPCS C1725
Hospital Charge Code	41561804
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

ZZ COOK BALLOON DILA/CATH5MMX10CM

Facility

$420.00

Service Code	HCPCS C1725
Hospital Charge Code	41561804
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

ZZ COOK BALLOON DILA/CATH 6MMX4CM

Facility

$420.00

Service Code	HCPCS C1725
Hospital Charge Code	41561802
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

ZZ COOK BALLOON DILA/CATH 6MMX4CM

Facility

$420.00

Service Code	HCPCS C1725
Hospital Charge Code	41561802
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

ZZ COOK BALLOON DILA/CATH 6MMX6CM

Facility

$420.00

Service Code	HCPCS C1725
Hospital Charge Code	41561806
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

ZZ COOK BALLOON DILA/CATH 6MMX6CM

Facility

$420.00

Service Code	HCPCS C1725
Hospital Charge Code	41561806
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

ZZ COOK BEACON TIP TORCON NB.

Facility

$37.70

Hospital Charge Code	41561883
Hospital Revenue Code	270
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$30.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.85
Rate for Payer: Aetna Government	$18.85
Rate for Payer: Brighton Health Commercial	$28.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.64
Rate for Payer: Group Health Inc Commercial	$18.85
Rate for Payer: Group Health Inc Medicare	$13.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.85
Rate for Payer: Hamaspik Choice Inc Medicare	$18.85

ZZ COOK BX NDL CT13 15CM

Facility

$105.61

Hospital Charge Code	41569572
Hospital Revenue Code	270
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$84.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$52.80
Rate for Payer: Aetna Government	$52.80
Rate for Payer: Brighton Health Commercial	$79.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$84.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.81
Rate for Payer: Group Health Inc Commercial	$52.80
Rate for Payer: Group Health Inc Medicare	$36.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.80
Rate for Payer: Hamaspik Choice Inc Medicare	$52.80

ZZ COOK BX NDL G11 10CM

Facility

$105.61

Hospital Charge Code	41569569
Hospital Revenue Code	270
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$84.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$52.80
Rate for Payer: Aetna Government	$52.80
Rate for Payer: Brighton Health Commercial	$79.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$84.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.81
Rate for Payer: Group Health Inc Commercial	$52.80
Rate for Payer: Group Health Inc Medicare	$36.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.80
Rate for Payer: Hamaspik Choice Inc Medicare	$52.80

ZZ COOK BX NDL G11 5CM

Facility

$105.61

Hospital Charge Code	41569570
Hospital Revenue Code	270
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$84.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$52.80
Rate for Payer: Aetna Government	$52.80
Rate for Payer: Brighton Health Commercial	$79.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$84.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.81
Rate for Payer: Group Health Inc Commercial	$52.80
Rate for Payer: Group Health Inc Medicare	$36.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.80
Rate for Payer: Hamaspik Choice Inc Medicare	$52.80

ZZ COOK BX NDL G13 10CM

Facility

$105.61

Hospital Charge Code	41569571
Hospital Revenue Code	270
Min. Negotiated Rate	$36.96
Max. Negotiated Rate	$84.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$52.80
Rate for Payer: Aetna Government	$52.80
Rate for Payer: Brighton Health Commercial	$79.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$84.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.81
Rate for Payer: Group Health Inc Commercial	$52.80
Rate for Payer: Group Health Inc Medicare	$36.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.80
Rate for Payer: Hamaspik Choice Inc Medicare	$52.80

ZZ COOK CELECT FLTR FEMORAL APP.

Facility

$2,840.50

Hospital Charge Code	41567736
Hospital Revenue Code	270
Min. Negotiated Rate	$994.18
Max. Negotiated Rate	$2,272.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,562.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,420.25
Rate for Payer: Aetna Government	$1,420.25
Rate for Payer: Brighton Health Commercial	$2,130.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,272.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,931.54
Rate for Payer: Group Health Inc Commercial	$1,420.25
Rate for Payer: Group Health Inc Medicare	$994.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,420.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,420.25

ZZCOOK CELECT FLTR JUGULAR APP.

Facility

$2,840.50

Hospital Charge Code	41567735
Hospital Revenue Code	270
Min. Negotiated Rate	$994.18
Max. Negotiated Rate	$2,272.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,562.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,420.25
Rate for Payer: Aetna Government	$1,420.25
Rate for Payer: Brighton Health Commercial	$2,130.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,272.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,931.54
Rate for Payer: Group Health Inc Commercial	$1,420.25
Rate for Payer: Group Health Inc Medicare	$994.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,420.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,420.25

ZZ COOK CLOVERSNARE VASCULAR RET

Facility

$220.00

Hospital Charge Code	41564631
Hospital Revenue Code	272
Min. Negotiated Rate	$77.00
Max. Negotiated Rate	$176.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$110.00
Rate for Payer: Aetna Government	$110.00
Rate for Payer: Brighton Health Commercial	$165.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$149.60
Rate for Payer: Group Health Inc Commercial	$110.00
Rate for Payer: Group Health Inc Medicare	$77.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.00
Rate for Payer: Hamaspik Choice Inc Medicare	$110.00

ZZ COOK COPE GI SUTURE ANCHOR

Facility

$134.08

Hospital Charge Code	41567754
Hospital Revenue Code	270
Min. Negotiated Rate	$46.93
Max. Negotiated Rate	$107.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$73.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$67.04
Rate for Payer: Aetna Government	$67.04
Rate for Payer: Brighton Health Commercial	$100.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$107.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$91.17
Rate for Payer: Group Health Inc Commercial	$67.04
Rate for Payer: Group Health Inc Medicare	$46.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.04
Rate for Payer: Hamaspik Choice Inc Medicare	$67.04

ZZ COOK DAWSON MUELLER DRAINAGE

Facility

$163.20

Hospital Charge Code	41561800
Hospital Revenue Code	270
Min. Negotiated Rate	$57.12
Max. Negotiated Rate	$130.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$81.60
Rate for Payer: Aetna Government	$81.60
Rate for Payer: Brighton Health Commercial	$122.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$130.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$110.98
Rate for Payer: Group Health Inc Commercial	$81.60
Rate for Payer: Group Health Inc Medicare	$57.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.60
Rate for Payer: Hamaspik Choice Inc Medicare	$81.60

ZZ COOK DAWSON MULLER DRAINAGE

Facility

$772.35

Hospital Charge Code	41568902
Hospital Revenue Code	270
Min. Negotiated Rate	$270.32
Max. Negotiated Rate	$617.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$424.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$386.18
Rate for Payer: Aetna Government	$386.18
Rate for Payer: Brighton Health Commercial	$579.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$617.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$525.20
Rate for Payer: Group Health Inc Commercial	$386.18
Rate for Payer: Group Health Inc Medicare	$270.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$386.18
Rate for Payer: Hamaspik Choice Inc Medicare	$386.18

ZZ COOK FLEXOR CHK-FLO INTRO SET

Facility

$420.00

Hospital Charge Code	41563134
Hospital Revenue Code	272
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$336.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$210.00
Rate for Payer: Aetna Government	$210.00
Rate for Payer: Brighton Health Commercial	$315.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$336.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$285.60
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

ZZ COOK FORCE PRESS INJ

Facility

$248.06

Hospital Charge Code	41569573
Hospital Revenue Code	270
Min. Negotiated Rate	$86.82
Max. Negotiated Rate	$198.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$124.03
Rate for Payer: Aetna Government	$124.03
Rate for Payer: Brighton Health Commercial	$186.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.68
Rate for Payer: Group Health Inc Commercial	$124.03
Rate for Payer: Group Health Inc Medicare	$86.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$124.03
Rate for Payer: Hamaspik Choice Inc Medicare	$124.03

ZZ COOK GERMIA BX NDL

Facility

$388.40

Hospital Charge Code	41569786
Hospital Revenue Code	270
Min. Negotiated Rate	$135.94
Max. Negotiated Rate	$310.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$194.20
Rate for Payer: Aetna Government	$194.20
Rate for Payer: Brighton Health Commercial	$291.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$310.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$264.11
Rate for Payer: Group Health Inc Commercial	$194.20
Rate for Payer: Group Health Inc Medicare	$135.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$194.20
Rate for Payer: Hamaspik Choice Inc Medicare	$194.20

ZZ COOK GPC POLYETHYLENE CATH

Facility

$68.88

Hospital Charge Code	41540608
Hospital Revenue Code	272
Min. Negotiated Rate	$24.11
Max. Negotiated Rate	$55.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.44
Rate for Payer: Aetna Government	$34.44
Rate for Payer: Brighton Health Commercial	$51.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.84
Rate for Payer: Group Health Inc Commercial	$34.44
Rate for Payer: Group Health Inc Medicare	$24.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.44
Rate for Payer: Hamaspik Choice Inc Medicare	$34.44

Know your out-of-pocket cost for care.

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