St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ EL FOGARTY 5.5F

Facility

$178.72

Hospital Charge Code	41561898
Hospital Revenue Code	270
Min. Negotiated Rate	$62.55
Max. Negotiated Rate	$142.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$89.36
Rate for Payer: Aetna Government	$89.36
Rate for Payer: Brighton Health Commercial	$134.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$121.53
Rate for Payer: Group Health Inc Commercial	$89.36
Rate for Payer: Group Health Inc Medicare	$62.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.36
Rate for Payer: Hamaspik Choice Inc Medicare	$89.36

ZZ EMBOCATH

Facility

$708.75

Service Code	HCPCS C1884
Hospital Charge Code	41569767
Hospital Revenue Code	278
Min. Negotiated Rate	$354.38
Max. Negotiated Rate	$354.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.38
Rate for Payer: Hamaspik Choice Inc Medicare	$354.38

ZZ EMBOCATH

Facility

$708.75

Service Code	HCPCS C1884
Hospital Charge Code	41569767
Hospital Revenue Code	278
Min. Negotiated Rate	$180.07
Max. Negotiated Rate	$744.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$389.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$425.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$354.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$407.53
Rate for Payer: EmblemHealth Commercial	$354.38
Rate for Payer: Fidelis Medicare Advantage	$744.19
Rate for Payer: Group Health Inc Commercial	$354.38
Rate for Payer: Group Health Inc Medicare	$248.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.38
Rate for Payer: Hamaspik Choice Inc Medicare	$354.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$460.69

ZZ EMBOLIZA COIL

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41560054
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41560054
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

ZZ EMBOLIZA COIL 35 3 3

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567334
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 35 3 3

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567334
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

ZZ EMBOLIZA COIL 35 3 4

Facility

$66.98

Hospital Charge Code	41567335
Hospital Revenue Code	270
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$53.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.49
Rate for Payer: Aetna Government	$33.49
Rate for Payer: Brighton Health Commercial	$50.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.55
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 38 2 3

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567336
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

ZZ EMBOLIZA COIL 38 2 3

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567336
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 38 3 2

Facility

$66.98

Hospital Charge Code	41567337
Hospital Revenue Code	270
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$53.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.49
Rate for Payer: Aetna Government	$33.49
Rate for Payer: Brighton Health Commercial	$50.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.55
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 38 3 5

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567338
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 38 3 5

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567338
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

ZZ EMBOLIZA COIL 38 4 3

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567339
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 38 4 3

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567339
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

ZZ EMBOLIZA COIL 38 5 10

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567141
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

ZZ EMBOLIZA COIL 38 5 10

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567141
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 38 5 15

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567142
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

ZZ EMBOLIZA COIL 38 5 15

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567142
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 38 5 5

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567341
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 38 5 5

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567341
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

ZZ EMBOLIZA COIL 38 5 8

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567340
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

ZZ EMBOLIZA COIL 38 5 8

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567340
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 52 10 15

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567342
Hospital Revenue Code	278
Min. Negotiated Rate	$33.49
Max. Negotiated Rate	$33.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49

ZZ EMBOLIZA COIL 52 10 15

Facility

$66.98

Service Code	HCPCS C1884
Hospital Charge Code	41567342
Hospital Revenue Code	278
Min. Negotiated Rate	$23.44
Max. Negotiated Rate	$180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$40.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.51
Rate for Payer: EmblemHealth Commercial	$33.49
Rate for Payer: Fidelis Medicare Advantage	$70.33
Rate for Payer: Group Health Inc Commercial	$33.49
Rate for Payer: Group Health Inc Medicare	$23.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.49
Rate for Payer: Hamaspik Choice Inc Medicare	$33.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.54

Know your out-of-pocket cost for care.

All Charges