St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ DRAINAGE/N-U/10F-26CM

Facility

$219.01

Service Code	HCPCS C1729
Hospital Charge Code	41569332
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$109.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.50
Rate for Payer: Hamaspik Choice Inc Medicare	$109.50

ZZ DRAINAGE/N-U/8F-22CM

Facility

$223.26

Hospital Charge Code	41569333
Hospital Revenue Code	270
Min. Negotiated Rate	$78.14
Max. Negotiated Rate	$178.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$111.63
Rate for Payer: Aetna Government	$111.63
Rate for Payer: Brighton Health Commercial	$167.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$178.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$151.82
Rate for Payer: Group Health Inc Commercial	$111.63
Rate for Payer: Group Health Inc Medicare	$78.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.63
Rate for Payer: Hamaspik Choice Inc Medicare	$111.63

ZZ DRAINAGE/N-U/8F-24CM

Facility

$223.26

Service Code	HCPCS C1729
Hospital Charge Code	41569334
Hospital Revenue Code	278
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$234.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.42
Rate for Payer: Aetna Government	$2.42
Rate for Payer: Brighton Health Commercial	$133.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.37
Rate for Payer: EmblemHealth Commercial	$111.63
Rate for Payer: Fidelis Medicare Advantage	$234.42
Rate for Payer: Group Health Inc Commercial	$111.63
Rate for Payer: Group Health Inc Medicare	$78.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.63
Rate for Payer: Hamaspik Choice Inc Medicare	$111.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$145.12

ZZ DRAINAGE/N-U/8F-24CM

Facility

$223.26

Service Code	HCPCS C1729
Hospital Charge Code	41569334
Hospital Revenue Code	278
Min. Negotiated Rate	$111.63
Max. Negotiated Rate	$111.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.63
Rate for Payer: Hamaspik Choice Inc Medicare	$111.63

ZZ DRAINAGE/N-U/8F-26CM

Facility

$223.26

Service Code	HCPCS C1729
Hospital Charge Code	41569335
Hospital Revenue Code	278
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$234.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.42
Rate for Payer: Aetna Government	$2.42
Rate for Payer: Brighton Health Commercial	$133.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.37
Rate for Payer: EmblemHealth Commercial	$111.63
Rate for Payer: Fidelis Medicare Advantage	$234.42
Rate for Payer: Group Health Inc Commercial	$111.63
Rate for Payer: Group Health Inc Medicare	$78.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.63
Rate for Payer: Hamaspik Choice Inc Medicare	$111.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$145.12

ZZ DRAINAGE/N-U/8F-26CM

Facility

$223.26

Service Code	HCPCS C1729
Hospital Charge Code	41569335
Hospital Revenue Code	278
Min. Negotiated Rate	$111.63
Max. Negotiated Rate	$111.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.63
Rate for Payer: Hamaspik Choice Inc Medicare	$111.63

ZZ DRAINAGE/PCN/10FANNA PASCAL.

Facility

$121.74

Service Code	HCPCS C1725
Hospital Charge Code	41569339
Hospital Revenue Code	278
Min. Negotiated Rate	$60.87
Max. Negotiated Rate	$60.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.87
Rate for Payer: Hamaspik Choice Inc Medicare	$60.87

ZZ DRAINAGE/PCN/10FANNA PASCAL.

Facility

$121.74

Service Code	HCPCS C1725
Hospital Charge Code	41569339
Hospital Revenue Code	278
Min. Negotiated Rate	$42.61
Max. Negotiated Rate	$127.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$73.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$70.00
Rate for Payer: EmblemHealth Commercial	$60.87
Rate for Payer: Fidelis Medicare Advantage	$127.83
Rate for Payer: Group Health Inc Commercial	$60.87
Rate for Payer: Group Health Inc Medicare	$42.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.87
Rate for Payer: Hamaspik Choice Inc Medicare	$60.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$79.13

ZZ DRAINAGE/PCN/10F FIRM

Facility

$172.23

Service Code	HCPCS C1729
Hospital Charge Code	41569340
Hospital Revenue Code	278
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$180.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.42
Rate for Payer: Aetna Government	$2.42
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/PCN/10F FIRM

Facility

$172.23

Service Code	HCPCS C1729
Hospital Charge Code	41569340
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/PCN/12F

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569341
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/PCN/12F

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569341
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/PCN/8F FIRM

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569344
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/PCN/8F FIRM

Facility

$172.23

Service Code	HCPCS C1725
Hospital Charge Code	41569344
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/SUMP/12F LOCKING

Facility

$244.52

Service Code	HCPCS C1725
Hospital Charge Code	41569490
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$256.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$134.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$146.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$122.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.60
Rate for Payer: EmblemHealth Commercial	$122.26
Rate for Payer: Fidelis Medicare Advantage	$256.75
Rate for Payer: Group Health Inc Commercial	$122.26
Rate for Payer: Group Health Inc Medicare	$85.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.26
Rate for Payer: Hamaspik Choice Inc Medicare	$122.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$158.94

ZZ DRAINAGE/SUMP/12F LOCKING

Facility

$244.52

Service Code	HCPCS C1725
Hospital Charge Code	41569490
Hospital Revenue Code	278
Min. Negotiated Rate	$122.26
Max. Negotiated Rate	$122.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.26
Rate for Payer: Hamaspik Choice Inc Medicare	$122.26

ZZ D-STAT FLOWABLE HEMOSTAT

Facility

$262.50

Service Code	HCPCS C1725
Hospital Charge Code	41567893
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$157.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: EmblemHealth Commercial	$131.25
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

ZZ D-STAT FLOWABLE HEMOSTAT

Facility

$262.50

Service Code	HCPCS C1725
Hospital Charge Code	41567893
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

ZZ DURO-JECT BONE CEME. INJ.

Facility

$484.50

Hospital Charge Code	41569964
Hospital Revenue Code	279
Min. Negotiated Rate	$169.58
Max. Negotiated Rate	$387.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$266.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$242.25
Rate for Payer: Aetna Government	$242.25
Rate for Payer: Brighton Health Commercial	$363.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$387.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$329.46
Rate for Payer: Group Health Inc Commercial	$242.25
Rate for Payer: Group Health Inc Medicare	$169.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.25
Rate for Payer: Hamaspik Choice Inc Medicare	$242.25

ZZ EASY CORE BIOPSY SYS 18GX10CM

Facility

$127.40

Hospital Charge Code	41569897
Hospital Revenue Code	270
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$101.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.70
Rate for Payer: Aetna Government	$63.70
Rate for Payer: Brighton Health Commercial	$95.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$101.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.63
Rate for Payer: Group Health Inc Commercial	$63.70
Rate for Payer: Group Health Inc Medicare	$44.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.70
Rate for Payer: Hamaspik Choice Inc Medicare	$63.70

ZZ EBU GUIDE CATHETER

Facility

$116.60

Service Code	HCPCS C1725
Hospital Charge Code	41569912
Hospital Revenue Code	278
Min. Negotiated Rate	$58.30
Max. Negotiated Rate	$58.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.30
Rate for Payer: Hamaspik Choice Inc Medicare	$58.30

ZZ EBU GUIDE CATHETER

Facility

$116.60

Service Code	HCPCS C1725
Hospital Charge Code	41569912
Hospital Revenue Code	278
Min. Negotiated Rate	$40.81
Max. Negotiated Rate	$122.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$64.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$69.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.04
Rate for Payer: EmblemHealth Commercial	$58.30
Rate for Payer: Fidelis Medicare Advantage	$122.43
Rate for Payer: Group Health Inc Commercial	$58.30
Rate for Payer: Group Health Inc Medicare	$40.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.30
Rate for Payer: Hamaspik Choice Inc Medicare	$58.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$75.79

ZZ EDLIFE FOG. CLOT CATH

Facility

$552.83

Hospital Charge Code	41569563
Hospital Revenue Code	270
Min. Negotiated Rate	$193.49
Max. Negotiated Rate	$442.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$304.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$276.42
Rate for Payer: Aetna Government	$276.42
Rate for Payer: Brighton Health Commercial	$414.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$442.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$375.92
Rate for Payer: Group Health Inc Commercial	$276.42
Rate for Payer: Group Health Inc Medicare	$193.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$276.42
Rate for Payer: Hamaspik Choice Inc Medicare	$276.42

ZZ EKOS ENDOVASCULAR DEVICE 12CM

Facility

$3,395.00

Hospital Charge Code	41540603
Hospital Revenue Code	272
Min. Negotiated Rate	$1,188.25
Max. Negotiated Rate	$2,716.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,867.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,697.50
Rate for Payer: Aetna Government	$1,697.50
Rate for Payer: Brighton Health Commercial	$2,546.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,716.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,308.60
Rate for Payer: Group Health Inc Commercial	$1,697.50
Rate for Payer: Group Health Inc Medicare	$1,188.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,697.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,697.50

ZZ EKOS ENDOVASCULAR DEVICE 18CM

Facility

$3,395.00

Hospital Charge Code	41540604
Hospital Revenue Code	272
Min. Negotiated Rate	$1,188.25
Max. Negotiated Rate	$2,716.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,867.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,697.50
Rate for Payer: Aetna Government	$1,697.50
Rate for Payer: Brighton Health Commercial	$2,546.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,716.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,308.60
Rate for Payer: Group Health Inc Commercial	$1,697.50
Rate for Payer: Group Health Inc Medicare	$1,188.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,697.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,697.50

Know your out-of-pocket cost for care.

All Charges