St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ COOK MENCINI DOUBLE HYST. CATH

Facility

$263.18

Service Code	HCPCS C2628
Hospital Charge Code	41561884
Hospital Revenue Code	278
Min. Negotiated Rate	$92.11
Max. Negotiated Rate	$276.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$203.48
Rate for Payer: Aetna Government	$203.48
Rate for Payer: Brighton Health Commercial	$157.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$151.33
Rate for Payer: EmblemHealth Commercial	$131.59
Rate for Payer: Fidelis Medicare Advantage	$276.34
Rate for Payer: Group Health Inc Commercial	$131.59
Rate for Payer: Group Health Inc Medicare	$92.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.59
Rate for Payer: Hamaspik Choice Inc Medicare	$131.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$171.07

ZZ COOK MENCINI DOUBLE HYST. CATH

Facility

$263.18

Service Code	HCPCS C2628
Hospital Charge Code	41561884
Hospital Revenue Code	278
Min. Negotiated Rate	$131.59
Max. Negotiated Rate	$131.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.59
Rate for Payer: Hamaspik Choice Inc Medicare	$131.59

ZZ COOK NEFF PERCUT ACS SET

Facility

$260.12

Hospital Charge Code	41569624
Hospital Revenue Code	270
Min. Negotiated Rate	$91.04
Max. Negotiated Rate	$208.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.06
Rate for Payer: Aetna Government	$130.06
Rate for Payer: Brighton Health Commercial	$195.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.88
Rate for Payer: Group Health Inc Commercial	$130.06
Rate for Payer: Group Health Inc Medicare	$91.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.06
Rate for Payer: Hamaspik Choice Inc Medicare	$130.06

ZZ COOKS DILATOR 10 38 20

Facility

$13.11

Hospital Charge Code	41567295
Hospital Revenue Code	270
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$10.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.56
Rate for Payer: Aetna Government	$6.56
Rate for Payer: Brighton Health Commercial	$9.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.91
Rate for Payer: Group Health Inc Commercial	$6.56
Rate for Payer: Group Health Inc Medicare	$4.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.56
Rate for Payer: Hamaspik Choice Inc Medicare	$6.56

ZZ COOKS DILATOR 11 38 20

Facility

$16.31

Hospital Charge Code	41567296
Hospital Revenue Code	270
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$13.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.16
Rate for Payer: Aetna Government	$8.16
Rate for Payer: Brighton Health Commercial	$12.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.09
Rate for Payer: Group Health Inc Commercial	$8.16
Rate for Payer: Group Health Inc Medicare	$5.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.16
Rate for Payer: Hamaspik Choice Inc Medicare	$8.16

ZZ COOKS DILATOR 12 38 20

Facility

$16.31

Hospital Charge Code	41567297
Hospital Revenue Code	270
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$13.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.16
Rate for Payer: Aetna Government	$8.16
Rate for Payer: Brighton Health Commercial	$12.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.09
Rate for Payer: Group Health Inc Commercial	$8.16
Rate for Payer: Group Health Inc Medicare	$5.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.16
Rate for Payer: Hamaspik Choice Inc Medicare	$8.16

ZZ COOKS DILATOR 14 38 20

Facility

$16.31

Hospital Charge Code	41567298
Hospital Revenue Code	270
Min. Negotiated Rate	$5.71
Max. Negotiated Rate	$13.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.16
Rate for Payer: Aetna Government	$8.16
Rate for Payer: Brighton Health Commercial	$12.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.09
Rate for Payer: Group Health Inc Commercial	$8.16
Rate for Payer: Group Health Inc Medicare	$5.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.16
Rate for Payer: Hamaspik Choice Inc Medicare	$8.16

ZZ COOKS DILATOR 16 38 20

Facility

$27.65

Hospital Charge Code	41567294
Hospital Revenue Code	270
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$22.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.82
Rate for Payer: Aetna Government	$13.82
Rate for Payer: Brighton Health Commercial	$20.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.80
Rate for Payer: Group Health Inc Commercial	$13.82
Rate for Payer: Group Health Inc Medicare	$9.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.82
Rate for Payer: Hamaspik Choice Inc Medicare	$13.82

ZZ COOKS DILATOR 8 38 20

Facility

$13.11

Hospital Charge Code	41567299
Hospital Revenue Code	270
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$10.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.56
Rate for Payer: Aetna Government	$6.56
Rate for Payer: Brighton Health Commercial	$9.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.91
Rate for Payer: Group Health Inc Commercial	$6.56
Rate for Payer: Group Health Inc Medicare	$4.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.56
Rate for Payer: Hamaspik Choice Inc Medicare	$6.56

ZZ COOKS DILATOR 9 38 20

Facility

$13.11

Hospital Charge Code	41567300
Hospital Revenue Code	270
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$10.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.56
Rate for Payer: Aetna Government	$6.56
Rate for Payer: Brighton Health Commercial	$9.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.91
Rate for Payer: Group Health Inc Commercial	$6.56
Rate for Payer: Group Health Inc Medicare	$4.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.56
Rate for Payer: Hamaspik Choice Inc Medicare	$6.56

ZZ COOK TULIP FILTER RETRIEVALSET

Facility

$595.00

Hospital Charge Code	41567759
Hospital Revenue Code	270
Min. Negotiated Rate	$208.25
Max. Negotiated Rate	$476.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$327.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$297.50
Rate for Payer: Aetna Government	$297.50
Rate for Payer: Brighton Health Commercial	$446.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$476.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$404.60
Rate for Payer: Group Health Inc Commercial	$297.50
Rate for Payer: Group Health Inc Medicare	$208.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$297.50
Rate for Payer: Hamaspik Choice Inc Medicare	$297.50

ZZ COOK ULTRATHANE SUP.PUB.SET

Facility

$135.90

Service Code	HCPCS C2627
Hospital Charge Code	41561926
Hospital Revenue Code	278
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.95
Rate for Payer: Hamaspik Choice Inc Medicare	$67.95

ZZ COOK ULTRATHANE SUP.PUB.SET

Facility

$135.90

Service Code	HCPCS C2627
Hospital Charge Code	41561926
Hospital Revenue Code	278
Min. Negotiated Rate	$47.56
Max. Negotiated Rate	$142.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.04
Rate for Payer: Aetna Government	$73.04
Rate for Payer: Brighton Health Commercial	$81.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.14
Rate for Payer: EmblemHealth Commercial	$67.95
Rate for Payer: Fidelis Medicare Advantage	$142.70
Rate for Payer: Group Health Inc Commercial	$67.95
Rate for Payer: Group Health Inc Medicare	$47.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.95
Rate for Payer: Hamaspik Choice Inc Medicare	$67.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$88.34

ZZ COOK WILL-OG GASTRO SET

Facility

$297.00

Hospital Charge Code	41561909
Hospital Revenue Code	270
Min. Negotiated Rate	$103.95
Max. Negotiated Rate	$237.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$163.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$148.50
Rate for Payer: Aetna Government	$148.50
Rate for Payer: Brighton Health Commercial	$222.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$237.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$201.96
Rate for Payer: Group Health Inc Commercial	$148.50
Rate for Payer: Group Health Inc Medicare	$103.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$148.50
Rate for Payer: Hamaspik Choice Inc Medicare	$148.50

ZZ COOK WILLS-OGLESBY GASTROSTOMY

Facility

$297.00

Hospital Charge Code	41561894
Hospital Revenue Code	270
Min. Negotiated Rate	$103.95
Max. Negotiated Rate	$237.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$163.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$148.50
Rate for Payer: Aetna Government	$148.50
Rate for Payer: Brighton Health Commercial	$222.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$237.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$201.96
Rate for Payer: Group Health Inc Commercial	$148.50
Rate for Payer: Group Health Inc Medicare	$103.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$148.50
Rate for Payer: Hamaspik Choice Inc Medicare	$148.50

ZZ COOK YUEH CATH. NEEDLE 4FR/10C

Facility

$38.40

Hospital Charge Code	41567753
Hospital Revenue Code	270
Min. Negotiated Rate	$13.44
Max. Negotiated Rate	$30.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.20
Rate for Payer: Aetna Government	$19.20
Rate for Payer: Brighton Health Commercial	$28.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.11
Rate for Payer: Group Health Inc Commercial	$19.20
Rate for Payer: Group Health Inc Medicare	$13.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.20
Rate for Payer: Hamaspik Choice Inc Medicare	$19.20

ZZ COOK ZILVER 518 STENT

Facility

$3,100.00

Service Code	HCPCS C1874
Hospital Charge Code	41561808
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$3,255.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,705.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,860.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,550.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,782.50
Rate for Payer: EmblemHealth Commercial	$1,550.00
Rate for Payer: Fidelis Medicare Advantage	$3,255.00
Rate for Payer: Group Health Inc Commercial	$1,550.00
Rate for Payer: Group Health Inc Medicare	$1,085.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,550.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,550.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,015.00

ZZ COOK ZILVER 518 STENT

Facility

$3,100.00

Service Code	HCPCS C1874
Hospital Charge Code	41561809
Hospital Revenue Code	278
Min. Negotiated Rate	$1,550.00
Max. Negotiated Rate	$1,550.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,550.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,550.00

ZZ COOK ZILVER 518 STENT

Facility

$3,100.00

Service Code	HCPCS C1874
Hospital Charge Code	41561809
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$3,255.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,705.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,860.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,550.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,782.50
Rate for Payer: EmblemHealth Commercial	$1,550.00
Rate for Payer: Fidelis Medicare Advantage	$3,255.00
Rate for Payer: Group Health Inc Commercial	$1,550.00
Rate for Payer: Group Health Inc Medicare	$1,085.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,550.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,550.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,015.00

ZZ COOK ZILVER 518 STENT

Facility

$3,100.00

Service Code	HCPCS C1874
Hospital Charge Code	41561808
Hospital Revenue Code	278
Min. Negotiated Rate	$1,550.00
Max. Negotiated Rate	$1,550.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,550.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,550.00

ZZ COOK ZILVER 518 STENT

Facility

$3,100.00

Service Code	HCPCS C1874
Hospital Charge Code	41561807
Hospital Revenue Code	278
Min. Negotiated Rate	$1,550.00
Max. Negotiated Rate	$1,550.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,550.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,550.00

ZZ COOK ZILVER 518 STENT

Facility

$3,100.00

Service Code	HCPCS C1874
Hospital Charge Code	41561807
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$3,255.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,705.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,860.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,550.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,782.50
Rate for Payer: EmblemHealth Commercial	$1,550.00
Rate for Payer: Fidelis Medicare Advantage	$3,255.00
Rate for Payer: Group Health Inc Commercial	$1,550.00
Rate for Payer: Group Health Inc Medicare	$1,085.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,550.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,550.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,015.00

ZZ COOK ZILVER 635 STENT

Facility

$2,600.00

Service Code	HCPCS C1874
Hospital Charge Code	41561810
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,730.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,430.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,560.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,495.00
Rate for Payer: EmblemHealth Commercial	$1,300.00
Rate for Payer: Fidelis Medicare Advantage	$2,730.00
Rate for Payer: Group Health Inc Commercial	$1,300.00
Rate for Payer: Group Health Inc Medicare	$910.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,690.00

ZZ COOK ZILVER 635 STENT

Facility

$2,600.00

Service Code	HCPCS C1874
Hospital Charge Code	41561810
Hospital Revenue Code	278
Min. Negotiated Rate	$1,300.00
Max. Negotiated Rate	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,300.00

ZZ COPE MANDRIL WR 18-60

Facility

$89.66

Service Code	HCPCS C1769
Hospital Charge Code	41567093
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$94.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$53.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.55
Rate for Payer: EmblemHealth Commercial	$44.83
Rate for Payer: Fidelis Medicare Advantage	$94.14
Rate for Payer: Group Health Inc Commercial	$44.83
Rate for Payer: Group Health Inc Medicare	$31.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.83
Rate for Payer: Hamaspik Choice Inc Medicare	$44.83
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$58.28

Know your out-of-pocket cost for care.

All Charges