St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ EOVIST 10ML

Facility

$129.00

Service Code	HCPCS A9581
Hospital Charge Code	41561801
Hospital Revenue Code	255
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$103.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.73
Rate for Payer: Aetna Government	$14.73
Rate for Payer: Brighton Health Commercial	$96.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$103.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$87.72
Rate for Payer: Group Health Inc Commercial	$64.50
Rate for Payer: Group Health Inc Medicare	$45.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$64.50
Rate for Payer: Hamaspik Choice Inc Medicare	$64.50
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$14.76
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$15.65
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$15.65
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$15.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.85

ZZ EV3 AVIGO HYGRO GUIDEWIRE

Facility

$920.00

Service Code	HCPCS C1769
Hospital Charge Code	41564625
Hospital Revenue Code	278
Min. Negotiated Rate	$460.00
Max. Negotiated Rate	$460.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$460.00
Rate for Payer: Hamaspik Choice Inc Medicare	$460.00

ZZ EV3 AVIGO HYGRO GUIDEWIRE

Facility

$920.00

Service Code	HCPCS C1769
Hospital Charge Code	41564625
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$966.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$506.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$552.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$460.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$529.00
Rate for Payer: EmblemHealth Commercial	$460.00
Rate for Payer: Fidelis Medicare Advantage	$966.00
Rate for Payer: Group Health Inc Commercial	$460.00
Rate for Payer: Group Health Inc Medicare	$322.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$460.00
Rate for Payer: Hamaspik Choice Inc Medicare	$460.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$598.00

ZZ EV3 CONCERTO 2MM/6CM

Facility

$1,400.00

Hospital Charge Code	41564615
Hospital Revenue Code	272
Min. Negotiated Rate	$490.00
Max. Negotiated Rate	$1,120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$770.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$700.00
Rate for Payer: Aetna Government	$700.00
Rate for Payer: Brighton Health Commercial	$1,050.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$952.00
Rate for Payer: Group Health Inc Commercial	$700.00
Rate for Payer: Group Health Inc Medicare	$490.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$700.00

ZZ EV3 CONCERTO 3MM/8CM

Facility

$1,500.00

Hospital Charge Code	41563150
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$825.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$750.00
Rate for Payer: Aetna Government	$750.00
Rate for Payer: Brighton Health Commercial	$1,125.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,020.00
Rate for Payer: Group Health Inc Commercial	$750.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$750.00

ZZ EV3 CONCERTO 4MM/10CM

Facility

$1,500.00

Hospital Charge Code	41563151
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$825.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$750.00
Rate for Payer: Aetna Government	$750.00
Rate for Payer: Brighton Health Commercial	$1,125.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,020.00
Rate for Payer: Group Health Inc Commercial	$750.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$750.00

ZZ EV3 CONCERTO 5MM/15CM

Facility

$1,500.00

Hospital Charge Code	41563152
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$825.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$750.00
Rate for Payer: Aetna Government	$750.00
Rate for Payer: Brighton Health Commercial	$1,125.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,020.00
Rate for Payer: Group Health Inc Commercial	$750.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$750.00

ZZ EV3 CPNCERTO 7MM 30CM

Facility

$1,400.00

Hospital Charge Code	41564617
Hospital Revenue Code	272
Min. Negotiated Rate	$490.00
Max. Negotiated Rate	$1,120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$770.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$700.00
Rate for Payer: Aetna Government	$700.00
Rate for Payer: Brighton Health Commercial	$1,050.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$952.00
Rate for Payer: Group Health Inc Commercial	$700.00
Rate for Payer: Group Health Inc Medicare	$490.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$700.00

ZZ EV3 INFUSION CATHETER

Facility

$230.00

Service Code	HCPCS C1725
Hospital Charge Code	41561930
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$241.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$138.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$115.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.25
Rate for Payer: EmblemHealth Commercial	$115.00
Rate for Payer: Fidelis Medicare Advantage	$241.50
Rate for Payer: Group Health Inc Commercial	$115.00
Rate for Payer: Group Health Inc Medicare	$80.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$149.50

ZZ EV3 INFUSION CATHETER

Facility

$230.00

Service Code	HCPCS C1725
Hospital Charge Code	41561930
Hospital Revenue Code	278
Min. Negotiated Rate	$115.00
Max. Negotiated Rate	$115.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

ZZ EV3 REBAR-027 MICRO CATH

Facility

$550.00

Hospital Charge Code	41564629
Hospital Revenue Code	272
Min. Negotiated Rate	$192.50
Max. Negotiated Rate	$440.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$302.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.00
Rate for Payer: Aetna Government	$275.00
Rate for Payer: Brighton Health Commercial	$412.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$440.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$374.00
Rate for Payer: Group Health Inc Commercial	$275.00
Rate for Payer: Group Health Inc Medicare	$192.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$275.00

ZZ EV3 REBAR-18 MICRO CATH

Facility

$730.00

Hospital Charge Code	41564627
Hospital Revenue Code	272
Min. Negotiated Rate	$255.50
Max. Negotiated Rate	$584.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$401.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$365.00
Rate for Payer: Aetna Government	$365.00
Rate for Payer: Brighton Health Commercial	$547.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$584.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$496.40
Rate for Payer: Group Health Inc Commercial	$365.00
Rate for Payer: Group Health Inc Medicare	$255.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$365.00
Rate for Payer: Hamaspik Choice Inc Medicare	$365.00

ZZ EV3 REBAR MICRO CATHETER

Facility

$1,500.00

Hospital Charge Code	41563153
Hospital Revenue Code	272
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$825.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$750.00
Rate for Payer: Aetna Government	$750.00
Rate for Payer: Brighton Health Commercial	$1,125.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,020.00
Rate for Payer: Group Health Inc Commercial	$750.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$750.00

ZZ EV3 TRAILBLAZER CATHETER

Facility

$330.00

Hospital Charge Code	41561357
Hospital Revenue Code	272
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$264.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$165.00
Rate for Payer: Aetna Government	$165.00
Rate for Payer: Brighton Health Commercial	$247.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$264.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.40
Rate for Payer: Group Health Inc Commercial	$165.00
Rate for Payer: Group Health Inc Medicare	$115.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00
Rate for Payer: Hamaspik Choice Inc Medicare	$165.00

ZZ EXCHANGE WIRE 35 260J3

Facility

$54.93

Service Code	HCPCS C1769
Hospital Charge Code	41567131
Hospital Revenue Code	278
Min. Negotiated Rate	$27.46
Max. Negotiated Rate	$27.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.46
Rate for Payer: Hamaspik Choice Inc Medicare	$27.46

ZZ EXCHANGE WIRE 35 260J3

Facility

$54.93

Service Code	HCPCS C1769
Hospital Charge Code	41567131
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$57.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$32.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.58
Rate for Payer: EmblemHealth Commercial	$27.46
Rate for Payer: Fidelis Medicare Advantage	$57.68
Rate for Payer: Group Health Inc Commercial	$27.46
Rate for Payer: Group Health Inc Medicare	$19.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.46
Rate for Payer: Hamaspik Choice Inc Medicare	$27.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.70

ZZ EXTENSION SET 30 #4610

Facility

$192.05

Hospital Charge Code	41569001
Hospital Revenue Code	270
Min. Negotiated Rate	$67.22
Max. Negotiated Rate	$153.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$105.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$96.02
Rate for Payer: Aetna Government	$96.02
Rate for Payer: Brighton Health Commercial	$144.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$153.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$130.59
Rate for Payer: Group Health Inc Commercial	$96.02
Rate for Payer: Group Health Inc Medicare	$67.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$96.02
Rate for Payer: Hamaspik Choice Inc Medicare	$96.02

ZZ EXTERNAL FEEDING TUBE ADAPTER

Facility

$7.23

Hospital Charge Code	41569497
Hospital Revenue Code	270
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$5.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.62
Rate for Payer: Aetna Government	$3.62
Rate for Payer: Brighton Health Commercial	$5.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.92
Rate for Payer: Group Health Inc Commercial	$3.62
Rate for Payer: Group Health Inc Medicare	$2.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.62
Rate for Payer: Hamaspik Choice Inc Medicare	$3.62

ZZ FASTRACKER 325 KIT MCT

Facility

$1,059.59

Hospital Charge Code	41567286
Hospital Revenue Code	270
Min. Negotiated Rate	$370.86
Max. Negotiated Rate	$847.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$582.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$529.80
Rate for Payer: Aetna Government	$529.80
Rate for Payer: Brighton Health Commercial	$794.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$847.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$720.52
Rate for Payer: Group Health Inc Commercial	$529.80
Rate for Payer: Group Health Inc Medicare	$370.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$529.80
Rate for Payer: Hamaspik Choice Inc Medicare	$529.80

ZZ FATHOM-16 STEERABLE GUIDE WIRE

Facility

$578.00

Hospital Charge Code	41569963
Hospital Revenue Code	279
Min. Negotiated Rate	$202.30
Max. Negotiated Rate	$462.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$317.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$289.00
Rate for Payer: Aetna Government	$289.00
Rate for Payer: Brighton Health Commercial	$433.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$462.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$393.04
Rate for Payer: Group Health Inc Commercial	$289.00
Rate for Payer: Group Health Inc Medicare	$202.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$289.00
Rate for Payer: Hamaspik Choice Inc Medicare	$289.00

ZZ FILTER/BIRDSNEST/FEMORAL

Facility

$1,807.85

Hospital Charge Code	41569498
Hospital Revenue Code	270
Min. Negotiated Rate	$632.75
Max. Negotiated Rate	$1,446.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$994.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$903.92
Rate for Payer: Aetna Government	$903.92
Rate for Payer: Brighton Health Commercial	$1,355.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,229.34
Rate for Payer: Group Health Inc Commercial	$903.92
Rate for Payer: Group Health Inc Medicare	$632.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$903.92
Rate for Payer: Hamaspik Choice Inc Medicare	$903.92

ZZ FILTER/BIRDSNEST/JUGULAR

Facility

$1,807.85

Hospital Charge Code	41569499
Hospital Revenue Code	270
Min. Negotiated Rate	$632.75
Max. Negotiated Rate	$1,446.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$994.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$903.92
Rate for Payer: Aetna Government	$903.92
Rate for Payer: Brighton Health Commercial	$1,355.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,229.34
Rate for Payer: Group Health Inc Commercial	$903.92
Rate for Payer: Group Health Inc Medicare	$632.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$903.92
Rate for Payer: Hamaspik Choice Inc Medicare	$903.92

ZZ FILTER/GREENFIELD SS/FEMORAL

Facility

$2,513.23

Service Code	HCPCS C1880
Hospital Charge Code	41569500
Hospital Revenue Code	278
Min. Negotiated Rate	$1,256.62
Max. Negotiated Rate	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,256.62

ZZ FILTER/GREENFIELD SS/FEMORAL

Facility

$2,513.23

Service Code	HCPCS C1880
Hospital Charge Code	41569500
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$2,638.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,382.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Brighton Health Commercial	$1,507.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,256.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,445.11
Rate for Payer: EmblemHealth Commercial	$1,256.62
Rate for Payer: Fidelis Medicare Advantage	$2,638.89
Rate for Payer: Group Health Inc Commercial	$1,256.62
Rate for Payer: Group Health Inc Medicare	$879.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,256.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,633.60

ZZ FILTER/GREENFIELD SS/JUNGULAR

Facility

$2,513.23

Service Code	HCPCS C1880
Hospital Charge Code	41569501
Hospital Revenue Code	278
Min. Negotiated Rate	$1,256.62
Max. Negotiated Rate	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,256.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,256.62

Know your out-of-pocket cost for care.

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