St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ COPE MANDRIL WR 18-60

Facility

$89.66

Service Code	HCPCS C1769
Hospital Charge Code	41567093
Hospital Revenue Code	278
Min. Negotiated Rate	$44.83
Max. Negotiated Rate	$44.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.83
Rate for Payer: Hamaspik Choice Inc Medicare	$44.83

ZZ CORDIS 4F C2 TEMPO 4

Facility

$42.00

Hospital Charge Code	41564619
Hospital Revenue Code	272
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$33.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.00
Rate for Payer: Aetna Government	$21.00
Rate for Payer: Brighton Health Commercial	$31.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.56
Rate for Payer: Group Health Inc Commercial	$21.00
Rate for Payer: Group Health Inc Medicare	$14.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.00
Rate for Payer: Hamaspik Choice Inc Medicare	$21.00

ZZ CORDIS AGILITY 14 014X025

Facility

$472.50

Service Code	HCPCS C1725
Hospital Charge Code	41569866
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$496.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$259.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$283.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$236.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$271.69
Rate for Payer: EmblemHealth Commercial	$236.25
Rate for Payer: Fidelis Medicare Advantage	$496.12
Rate for Payer: Group Health Inc Commercial	$236.25
Rate for Payer: Group Health Inc Medicare	$165.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$236.25
Rate for Payer: Hamaspik Choice Inc Medicare	$236.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$307.12

ZZ CORDIS AGILITY 14 014X025

Facility

$472.50

Service Code	HCPCS C1725
Hospital Charge Code	41569866
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$236.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$236.25
Rate for Payer: Hamaspik Choice Inc Medicare	$236.25

ZZ CORDIS BRIT TIP-SHTH 6X90

Facility

$184.28

Hospital Charge Code	41569629
Hospital Revenue Code	270
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$147.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$101.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$92.14
Rate for Payer: Aetna Government	$92.14
Rate for Payer: Brighton Health Commercial	$138.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$147.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$125.31
Rate for Payer: Group Health Inc Commercial	$92.14
Rate for Payer: Group Health Inc Medicare	$64.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$92.14
Rate for Payer: Hamaspik Choice Inc Medicare	$92.14

ZZ CORDIS BRIT TIP-SHTH 7X90

Facility

$184.28

Hospital Charge Code	41569630
Hospital Revenue Code	270
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$147.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$101.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$92.14
Rate for Payer: Aetna Government	$92.14
Rate for Payer: Brighton Health Commercial	$138.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$147.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$125.31
Rate for Payer: Group Health Inc Commercial	$92.14
Rate for Payer: Group Health Inc Medicare	$64.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$92.14
Rate for Payer: Hamaspik Choice Inc Medicare	$92.14

ZZ CORDIS EXOSEAL 5F/6F

Facility

$225.00

Hospital Charge Code	41563211
Hospital Revenue Code	272
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$180.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$112.50
Rate for Payer: Aetna Government	$112.50
Rate for Payer: Brighton Health Commercial	$168.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$180.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.00
Rate for Payer: Group Health Inc Commercial	$112.50
Rate for Payer: Group Health Inc Medicare	$78.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.50
Rate for Payer: Hamaspik Choice Inc Medicare	$112.50

ZZ CORDIS PROWLER PLUS 042X150

Facility

$997.50

Service Code	HCPCS C1725
Hospital Charge Code	41569867
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$1,047.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$548.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$598.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$498.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$573.56
Rate for Payer: EmblemHealth Commercial	$498.75
Rate for Payer: Fidelis Medicare Advantage	$1,047.38
Rate for Payer: Group Health Inc Commercial	$498.75
Rate for Payer: Group Health Inc Medicare	$349.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$498.75
Rate for Payer: Hamaspik Choice Inc Medicare	$498.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$648.38

ZZ CORDIS PROWLER PLUS 042X150

Facility

$997.50

Service Code	HCPCS C1725
Hospital Charge Code	41569867
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$498.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$498.75
Rate for Payer: Hamaspik Choice Inc Medicare	$498.75

ZZ COVER CAPS

Facility

$5.31

Hospital Charge Code	41567522
Hospital Revenue Code	270
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$4.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.66
Rate for Payer: Aetna Government	$2.66
Rate for Payer: Brighton Health Commercial	$3.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.61
Rate for Payer: Group Health Inc Commercial	$2.66
Rate for Payer: Group Health Inc Medicare	$1.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.66
Rate for Payer: Hamaspik Choice Inc Medicare	$2.66

ZZ COVIDIEN CATH KIT 14.5FX23CM

Facility

$790.00

Hospital Charge Code	41564609
Hospital Revenue Code	272
Min. Negotiated Rate	$276.50
Max. Negotiated Rate	$632.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$434.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$395.00
Rate for Payer: Aetna Government	$395.00
Rate for Payer: Brighton Health Commercial	$592.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$632.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$537.20
Rate for Payer: Group Health Inc Commercial	$395.00
Rate for Payer: Group Health Inc Medicare	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00

ZZ COVIDIEN MWA TUB/CHAMBER

Facility

$410.00

Hospital Charge Code	41567760
Hospital Revenue Code	270
Min. Negotiated Rate	$143.50
Max. Negotiated Rate	$328.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$225.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$205.00
Rate for Payer: Aetna Government	$205.00
Rate for Payer: Brighton Health Commercial	$307.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$328.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$278.80
Rate for Payer: Group Health Inc Commercial	$205.00
Rate for Payer: Group Health Inc Medicare	$143.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$205.00
Rate for Payer: Hamaspik Choice Inc Medicare	$205.00

ZZ CTH TRU-FIX 10F FX KIT

Facility

$38.63

Hospital Charge Code	41567287
Hospital Revenue Code	270
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$30.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.32
Rate for Payer: Aetna Government	$19.32
Rate for Payer: Brighton Health Commercial	$28.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.27
Rate for Payer: Group Health Inc Commercial	$19.32
Rate for Payer: Group Health Inc Medicare	$13.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.32
Rate for Payer: Hamaspik Choice Inc Medicare	$19.32

ZZ CTH TRU-FIX 6F FX KIT

Facility

$38.63

Hospital Charge Code	41567288
Hospital Revenue Code	270
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$30.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.32
Rate for Payer: Aetna Government	$19.32
Rate for Payer: Brighton Health Commercial	$28.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.27
Rate for Payer: Group Health Inc Commercial	$19.32
Rate for Payer: Group Health Inc Medicare	$13.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.32
Rate for Payer: Hamaspik Choice Inc Medicare	$19.32

ZZ CTH TRU-FIX 8F FX KIT

Facility

$38.63

Hospital Charge Code	41567289
Hospital Revenue Code	270
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$30.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.32
Rate for Payer: Aetna Government	$19.32
Rate for Payer: Brighton Health Commercial	$28.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.27
Rate for Payer: Group Health Inc Commercial	$19.32
Rate for Payer: Group Health Inc Medicare	$13.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.32
Rate for Payer: Hamaspik Choice Inc Medicare	$19.32

ZZ DIALTOR/FASCIAL/14F

Facility

$60.71

Hospital Charge Code	41569305
Hospital Revenue Code	270
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$48.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.36
Rate for Payer: Aetna Government	$30.36
Rate for Payer: Brighton Health Commercial	$45.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$41.28
Rate for Payer: Group Health Inc Commercial	$30.36
Rate for Payer: Group Health Inc Medicare	$21.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.36
Rate for Payer: Hamaspik Choice Inc Medicare	$30.36

ZZ DIALTOR/FASCIAL/28F

Facility

$58.47

Hospital Charge Code	41569312
Hospital Revenue Code	270
Min. Negotiated Rate	$20.46
Max. Negotiated Rate	$46.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.24
Rate for Payer: Aetna Government	$29.24
Rate for Payer: Brighton Health Commercial	$43.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.76
Rate for Payer: Group Health Inc Commercial	$29.24
Rate for Payer: Group Health Inc Medicare	$20.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.24
Rate for Payer: Hamaspik Choice Inc Medicare	$29.24

ZZ DIALYSIS TEMP/15CM MED COMP

Facility

$1,084.39

Service Code	HCPCS C1751
Hospital Charge Code	41569301
Hospital Revenue Code	278
Min. Negotiated Rate	$542.20
Max. Negotiated Rate	$542.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$542.20
Rate for Payer: Hamaspik Choice Inc Medicare	$542.20

ZZ DIALYSIS TEMP/15CM MED COMP

Facility

$1,084.39

Service Code	HCPCS C1751
Hospital Charge Code	41569301
Hospital Revenue Code	278
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$1,138.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$596.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.08
Rate for Payer: Aetna Government	$7.08
Rate for Payer: Brighton Health Commercial	$650.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$542.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$623.52
Rate for Payer: EmblemHealth Commercial	$542.20
Rate for Payer: Fidelis Medicare Advantage	$1,138.61
Rate for Payer: Group Health Inc Commercial	$542.20
Rate for Payer: Group Health Inc Medicare	$379.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$542.20
Rate for Payer: Hamaspik Choice Inc Medicare	$542.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$704.85

ZZ DIALYSIS TEMP/20CM MED COMP

Facility

$1,084.39

Hospital Charge Code	41569302
Hospital Revenue Code	270
Min. Negotiated Rate	$379.54
Max. Negotiated Rate	$867.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$596.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$542.20
Rate for Payer: Aetna Government	$542.20
Rate for Payer: Brighton Health Commercial	$813.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$867.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$737.39
Rate for Payer: Group Health Inc Commercial	$542.20
Rate for Payer: Group Health Inc Medicare	$379.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$542.20
Rate for Payer: Hamaspik Choice Inc Medicare	$542.20

ZZ DIGFLEX ANG 5/ST/63 NO

Facility

$48.55

Hospital Charge Code	41567238
Hospital Revenue Code	270
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$38.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.28
Rate for Payer: Aetna Government	$24.28
Rate for Payer: Brighton Health Commercial	$36.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.01
Rate for Payer: Group Health Inc Commercial	$24.28
Rate for Payer: Group Health Inc Medicare	$16.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.28
Rate for Payer: Hamaspik Choice Inc Medicare	$24.28

ZZ DILATOR 4 35 20

Facility

$16.31

Hospital Charge Code	41567301
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 DILATOR/FASCIAL/10F

Facility

$408.78

Hospital Charge Code	41569303
Hospital Revenue Code	270
Min. Negotiated Rate	$143.07
Max. Negotiated Rate	$327.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$204.39
Rate for Payer: Aetna Government	$204.39
Rate for Payer: Brighton Health Commercial	$306.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$327.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$277.97
Rate for Payer: Group Health Inc Commercial	$204.39
Rate for Payer: Group Health Inc Medicare	$143.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.39
Rate for Payer: Hamaspik Choice Inc Medicare	$204.39

ZZ DILATOR/FASCIAL/12F

Facility

$60.71

Hospital Charge Code	41569304
Hospital Revenue Code	270
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$48.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.36
Rate for Payer: Aetna Government	$30.36
Rate for Payer: Brighton Health Commercial	$45.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$41.28
Rate for Payer: Group Health Inc Commercial	$30.36
Rate for Payer: Group Health Inc Medicare	$21.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.36
Rate for Payer: Hamaspik Choice Inc Medicare	$30.36

ZZ DILATOR/FASCIAL/16F

Facility

$60.71

Hospital Charge Code	41569306
Hospital Revenue Code	270
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$48.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.36
Rate for Payer: Aetna Government	$30.36
Rate for Payer: Brighton Health Commercial	$45.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$41.28
Rate for Payer: Group Health Inc Commercial	$30.36
Rate for Payer: Group Health Inc Medicare	$21.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.36
Rate for Payer: Hamaspik Choice Inc Medicare	$30.36

Know your out-of-pocket cost for care.

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