St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ DISPOS CHIBA NDL 22 10

Facility

$21.98

Hospital Charge Code	41567087
Hospital Revenue Code	270
Min. Negotiated Rate	$7.69
Max. Negotiated Rate	$17.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.99
Rate for Payer: Aetna Government	$10.99
Rate for Payer: Brighton Health Commercial	$16.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.95
Rate for Payer: Group Health Inc Commercial	$10.99
Rate for Payer: Group Health Inc Medicare	$7.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.99
Rate for Payer: Hamaspik Choice Inc Medicare	$10.99

ZZ DISPOS CHIBA NDL 22 20

Facility

$21.98

Hospital Charge Code	41567088
Hospital Revenue Code	270
Min. Negotiated Rate	$7.69
Max. Negotiated Rate	$17.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.99
Rate for Payer: Aetna Government	$10.99
Rate for Payer: Brighton Health Commercial	$16.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.95
Rate for Payer: Group Health Inc Commercial	$10.99
Rate for Payer: Group Health Inc Medicare	$7.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.99
Rate for Payer: Hamaspik Choice Inc Medicare	$10.99

ZZ DISP TUMOR MASS NDL 18G/15CM

Facility

$58.83

Hospital Charge Code	41569720
Hospital Revenue Code	270
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$47.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.42
Rate for Payer: Aetna Government	$29.42
Rate for Payer: Brighton Health Commercial	$44.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.00
Rate for Payer: Group Health Inc Commercial	$29.42
Rate for Payer: Group Health Inc Medicare	$20.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.42
Rate for Payer: Hamaspik Choice Inc Medicare	$29.42

ZZ DISP VANSON BERG NDL 22G/25CM

Facility

$52.45

Hospital Charge Code	41569723
Hospital Revenue Code	270
Min. Negotiated Rate	$18.36
Max. Negotiated Rate	$41.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.22
Rate for Payer: Aetna Government	$26.22
Rate for Payer: Brighton Health Commercial	$39.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.67
Rate for Payer: Group Health Inc Commercial	$26.22
Rate for Payer: Group Health Inc Medicare	$18.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.22
Rate for Payer: Hamaspik Choice Inc Medicare	$26.22

ZZ DIS TIP WR W/HNDLE 38

Facility

$124.04

Hospital Charge Code	41567094
Hospital Revenue Code	270
Min. Negotiated Rate	$43.41
Max. Negotiated Rate	$99.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.02
Rate for Payer: Aetna Government	$62.02
Rate for Payer: Brighton Health Commercial	$93.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.35
Rate for Payer: Group Health Inc Commercial	$62.02
Rate for Payer: Group Health Inc Medicare	$43.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.02
Rate for Payer: Hamaspik Choice Inc Medicare	$62.02

ZZ DRAINAGE/ABCESS/THAL1600

Facility

$163.45

Service Code	HCPCS C1725
Hospital Charge Code	41569420
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$171.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$98.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.98
Rate for Payer: EmblemHealth Commercial	$81.72
Rate for Payer: Fidelis Medicare Advantage	$171.62
Rate for Payer: Group Health Inc Commercial	$81.72
Rate for Payer: Group Health Inc Medicare	$57.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.72
Rate for Payer: Hamaspik Choice Inc Medicare	$81.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.24

ZZ DRAINAGE/ABCESS/THAL1600

Facility

$163.45

Service Code	HCPCS C1725
Hospital Charge Code	41569420
Hospital Revenue Code	278
Min. Negotiated Rate	$81.72
Max. Negotiated Rate	$81.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.72
Rate for Payer: Hamaspik Choice Inc Medicare	$81.72

ZZ DRAINAGE/ABCESS/THAL2400

Facility

$163.45

Service Code	HCPCS C1725
Hospital Charge Code	41569419
Hospital Revenue Code	278
Min. Negotiated Rate	$81.72
Max. Negotiated Rate	$81.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.72
Rate for Payer: Hamaspik Choice Inc Medicare	$81.72

ZZ DRAINAGE/ABCESS/THAL2400

Facility

$163.45

Service Code	HCPCS C1725
Hospital Charge Code	41569419
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$171.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$98.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.98
Rate for Payer: EmblemHealth Commercial	$81.72
Rate for Payer: Fidelis Medicare Advantage	$171.62
Rate for Payer: Group Health Inc Commercial	$81.72
Rate for Payer: Group Health Inc Medicare	$57.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.72
Rate for Payer: Hamaspik Choice Inc Medicare	$81.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.24

ZZ DRAINAGE/APD/10F LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569421
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/10F LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569421
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$103.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: EmblemHealth Commercial	$86.12
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/10F NONLOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569422
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$103.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: EmblemHealth Commercial	$86.12
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/10F NONLOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569422
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/12F LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569423
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/12F LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569423
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$103.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: EmblemHealth Commercial	$86.12
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/12F NONLOCKING

Facility

$150.97

Service Code	HCPCS C1725
Hospital Charge Code	41569424
Hospital Revenue Code	278
Min. Negotiated Rate	$75.48
Max. Negotiated Rate	$75.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.48
Rate for Payer: Hamaspik Choice Inc Medicare	$75.48

ZZ DRAINAGE/APD/12F NONLOCKING

Facility

$150.97

Service Code	HCPCS C1725
Hospital Charge Code	41569424
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$158.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$83.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$90.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.81
Rate for Payer: EmblemHealth Commercial	$75.48
Rate for Payer: Fidelis Medicare Advantage	$158.52
Rate for Payer: Group Health Inc Commercial	$75.48
Rate for Payer: Group Health Inc Medicare	$52.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.48
Rate for Payer: Hamaspik Choice Inc Medicare	$75.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$98.13

ZZ DRAINAGE/APD/14F LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569425
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$103.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: EmblemHealth Commercial	$86.12
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/14F LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569425
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/8F LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569426
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/8F LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569426
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$103.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: EmblemHealth Commercial	$86.12
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/APD/8F NON LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569427
Hospital Revenue Code	278
Min. Negotiated Rate	$86.12
Max. Negotiated Rate	$86.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12

ZZ DRAINAGE/APD/8F NON LOCKING

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569427
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$103.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.03
Rate for Payer: EmblemHealth Commercial	$86.12
Rate for Payer: Fidelis Medicare Advantage	$180.84
Rate for Payer: Group Health Inc Commercial	$86.12
Rate for Payer: Group Health Inc Medicare	$60.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.12
Rate for Payer: Hamaspik Choice Inc Medicare	$86.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.95

ZZ DRAINAGE/BILIARY/8.5F/CAMLOC

Facility

$158.81

Service Code	HCPCS C1725
Hospital Charge Code	41569430
Hospital Revenue Code	278
Min. Negotiated Rate	$79.40
Max. Negotiated Rate	$79.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.40
Rate for Payer: Hamaspik Choice Inc Medicare	$79.40

ZZ DRAINAGE/BILIARY/8.5F/CAMLOC

Facility

$158.81

Service Code	HCPCS C1725
Hospital Charge Code	41569430
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$166.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$87.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$95.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$91.32
Rate for Payer: EmblemHealth Commercial	$79.40
Rate for Payer: Fidelis Medicare Advantage	$166.75
Rate for Payer: Group Health Inc Commercial	$79.40
Rate for Payer: Group Health Inc Medicare	$55.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.40
Rate for Payer: Hamaspik Choice Inc Medicare	$79.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$103.23

Know your out-of-pocket cost for care.

All Charges