St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ HEMOSPLIT 14.5F 23CM

Facility

$1,114.81

Service Code	HCPCS C1725
Hospital Charge Code	41569879
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$1,170.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$613.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$668.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$557.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$641.02
Rate for Payer: EmblemHealth Commercial	$557.40
Rate for Payer: Fidelis Medicare Advantage	$1,170.55
Rate for Payer: Group Health Inc Commercial	$557.40
Rate for Payer: Group Health Inc Medicare	$390.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$557.40
Rate for Payer: Hamaspik Choice Inc Medicare	$557.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$724.63

ZZ HEMOSPLIT 14.5F 23CM

Facility

$1,114.81

Service Code	HCPCS C1725
Hospital Charge Code	41569879
Hospital Revenue Code	278
Min. Negotiated Rate	$557.40
Max. Negotiated Rate	$557.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$557.40
Rate for Payer: Hamaspik Choice Inc Medicare	$557.40

ZZ HIGH PRESSURE CONECTO

Facility

$8.51

Hospital Charge Code	41567007
Hospital Revenue Code	270
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$6.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.26
Rate for Payer: Aetna Government	$4.26
Rate for Payer: Brighton Health Commercial	$6.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.79
Rate for Payer: Group Health Inc Commercial	$4.26
Rate for Payer: Group Health Inc Medicare	$2.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.26
Rate for Payer: Hamaspik Choice Inc Medicare	$4.26

ZZ HOMER MAMMALOK 20GA X 10CM

Facility

$60.00

Hospital Charge Code	41568749
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

ZZ HOMER MAMMALOK 20GA X 12.5CM

Facility

$12,816.53

Hospital Charge Code	41567737
Hospital Revenue Code	270
Min. Negotiated Rate	$4,485.79
Max. Negotiated Rate	$10,253.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,049.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,408.26
Rate for Payer: Aetna Government	$6,408.26
Rate for Payer: Brighton Health Commercial	$9,612.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10,253.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$8,715.24
Rate for Payer: Group Health Inc Commercial	$6,408.26
Rate for Payer: Group Health Inc Medicare	$4,485.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,408.26
Rate for Payer: Hamaspik Choice Inc Medicare	$6,408.26

ZZ HOMER MAMMALOK 20GA X 12.5CM

Facility

$62.00

Hospital Charge Code	41567762
Hospital Revenue Code	270
Min. Negotiated Rate	$21.70
Max. Negotiated Rate	$49.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.00
Rate for Payer: Aetna Government	$31.00
Rate for Payer: Brighton Health Commercial	$46.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$49.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.16
Rate for Payer: Group Health Inc Commercial	$31.00
Rate for Payer: Group Health Inc Medicare	$21.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.00
Rate for Payer: Hamaspik Choice Inc Medicare	$31.00

ZZ HOMER MAMMALOK 20GA X 3CM

Facility

$60.00

Hospital Charge Code	41568745
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

ZZ HOMER MAMMALOK 20GA X 5CM

Facility

$60.00

Hospital Charge Code	41568746
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

ZZ HOMER MAMMALOK 20GA X 7.5CM

Facility

$60.00

Hospital Charge Code	41568748
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

ZZ HOOK CATH 1/5/65/035

Facility

$53.87

Hospital Charge Code	41567246
Hospital Revenue Code	270
Min. Negotiated Rate	$18.85
Max. Negotiated Rate	$43.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.94
Rate for Payer: Aetna Government	$26.94
Rate for Payer: Brighton Health Commercial	$40.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.63
Rate for Payer: Group Health Inc Commercial	$26.94
Rate for Payer: Group Health Inc Medicare	$18.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.94
Rate for Payer: Hamaspik Choice Inc Medicare	$26.94

ZZ HP THREE WY STPCK #179779

Facility

$4.34

Hospital Charge Code	41569002
Hospital Revenue Code	270
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$3.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Brighton Health Commercial	$3.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.95
Rate for Payer: Group Health Inc Commercial	$2.17
Rate for Payer: Group Health Inc Medicare	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.17
Rate for Payer: Hamaspik Choice Inc Medicare	$2.17

ZZ HP THREE WY STPCK #PTWSC 2FLL

Facility

$4.34

Hospital Charge Code	41569003
Hospital Revenue Code	270
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$3.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.17
Rate for Payer: Aetna Government	$2.17
Rate for Payer: Brighton Health Commercial	$3.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.95
Rate for Payer: Group Health Inc Commercial	$2.17
Rate for Payer: Group Health Inc Medicare	$1.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.17
Rate for Payer: Hamaspik Choice Inc Medicare	$2.17

ZZ H/S CATHETER SET

Facility

$55.88

Service Code	HCPCS C1726
Hospital Charge Code	41567757
Hospital Revenue Code	278
Min. Negotiated Rate	$27.94
Max. Negotiated Rate	$27.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.94
Rate for Payer: Hamaspik Choice Inc Medicare	$27.94

ZZ H/S CATHETER SET

Facility

$55.88

Service Code	HCPCS C1726
Hospital Charge Code	41567757
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$58.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Brighton Health Commercial	$33.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.13
Rate for Payer: EmblemHealth Commercial	$27.94
Rate for Payer: Fidelis Medicare Advantage	$58.67
Rate for Payer: Group Health Inc Commercial	$27.94
Rate for Payer: Group Health Inc Medicare	$19.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.94
Rate for Payer: Hamaspik Choice Inc Medicare	$27.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.32

ZZ HYDR COT 5/100/SIM2/38

Facility

$159.82

Hospital Charge Code	41567242
Hospital Revenue Code	270
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$127.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$87.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$79.91
Rate for Payer: Aetna Government	$79.91
Rate for Payer: Brighton Health Commercial	$119.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$127.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.68
Rate for Payer: Group Health Inc Commercial	$79.91
Rate for Payer: Group Health Inc Medicare	$55.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.91
Rate for Payer: Hamaspik Choice Inc Medicare	$79.91

ZZ HYDRO COAT 5/100/AT/38

Facility

$159.82

Hospital Charge Code	41567239
Hospital Revenue Code	270
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$127.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$87.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$79.91
Rate for Payer: Aetna Government	$79.91
Rate for Payer: Brighton Health Commercial	$119.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$127.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.68
Rate for Payer: Group Health Inc Commercial	$79.91
Rate for Payer: Group Health Inc Medicare	$55.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.91
Rate for Payer: Hamaspik Choice Inc Medicare	$79.91

ZZ HYDRO COAT CTH C1/5/65

Facility

$159.82

Service Code	HCPCS C1725
Hospital Charge Code	41567240
Hospital Revenue Code	278
Min. Negotiated Rate	$79.91
Max. Negotiated Rate	$79.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.91
Rate for Payer: Hamaspik Choice Inc Medicare	$79.91

ZZ HYDRO COAT CTH C1/5/65

Facility

$159.82

Service Code	HCPCS C1725
Hospital Charge Code	41567240
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$167.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$87.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$95.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$91.90
Rate for Payer: EmblemHealth Commercial	$79.91
Rate for Payer: Fidelis Medicare Advantage	$167.81
Rate for Payer: Group Health Inc Commercial	$79.91
Rate for Payer: Group Health Inc Medicare	$55.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.91
Rate for Payer: Hamaspik Choice Inc Medicare	$79.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$103.88

ZZ HYDRO COAT CTH C2/5/65

Facility

$159.82

Hospital Charge Code	41567241
Hospital Revenue Code	270
Min. Negotiated Rate	$55.94
Max. Negotiated Rate	$127.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$87.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$79.91
Rate for Payer: Aetna Government	$79.91
Rate for Payer: Brighton Health Commercial	$119.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$127.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.68
Rate for Payer: Group Health Inc Commercial	$79.91
Rate for Payer: Group Health Inc Medicare	$55.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.91
Rate for Payer: Hamaspik Choice Inc Medicare	$79.91

ZZ HYSTEROSALPINGOGRAM TRAY

Facility

$50.60

Hospital Charge Code	41561895
Hospital Revenue Code	270
Min. Negotiated Rate	$17.71
Max. Negotiated Rate	$40.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.30
Rate for Payer: Aetna Government	$25.30
Rate for Payer: Brighton Health Commercial	$37.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.41
Rate for Payer: Group Health Inc Commercial	$25.30
Rate for Payer: Group Health Inc Medicare	$17.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.30
Rate for Payer: Hamaspik Choice Inc Medicare	$25.30

ZZ IMAGE TORQ CATH 65 NO S

Facility

$53.87

Service Code	HCPCS C1725
Hospital Charge Code	41567247
Hospital Revenue Code	278
Min. Negotiated Rate	$18.85
Max. Negotiated Rate	$56.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$32.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.98
Rate for Payer: EmblemHealth Commercial	$26.94
Rate for Payer: Fidelis Medicare Advantage	$56.56
Rate for Payer: Group Health Inc Commercial	$26.94
Rate for Payer: Group Health Inc Medicare	$18.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.94
Rate for Payer: Hamaspik Choice Inc Medicare	$26.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.02

ZZ IMAGE TORQ CATH 65 NO S

Facility

$53.87

Service Code	HCPCS C1725
Hospital Charge Code	41567247
Hospital Revenue Code	278
Min. Negotiated Rate	$26.94
Max. Negotiated Rate	$26.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.94
Rate for Payer: Hamaspik Choice Inc Medicare	$26.94

ZZ INFLATION DEVICE

Facility

$147.78

Hospital Charge Code	41569515
Hospital Revenue Code	270
Min. Negotiated Rate	$51.72
Max. Negotiated Rate	$118.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.89
Rate for Payer: Aetna Government	$73.89
Rate for Payer: Brighton Health Commercial	$110.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$118.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$100.49
Rate for Payer: Group Health Inc Commercial	$73.89
Rate for Payer: Group Health Inc Medicare	$51.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.89
Rate for Payer: Hamaspik Choice Inc Medicare	$73.89

ZZ INFLATOR

Facility

$130.41

Hospital Charge Code	41567500
Hospital Revenue Code	270
Min. Negotiated Rate	$45.64
Max. Negotiated Rate	$104.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$71.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.20
Rate for Payer: Aetna Government	$65.20
Rate for Payer: Brighton Health Commercial	$97.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$104.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.68
Rate for Payer: Group Health Inc Commercial	$65.20
Rate for Payer: Group Health Inc Medicare	$45.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.20
Rate for Payer: Hamaspik Choice Inc Medicare	$65.20

ZZ INFUSION CATH/FASTRACKER-18

Facility

$627.25

Service Code	HCPCS C1725
Hospital Charge Code	41569517
Hospital Revenue Code	278
Min. Negotiated Rate	$313.62
Max. Negotiated Rate	$313.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.62
Rate for Payer: Hamaspik Choice Inc Medicare	$313.62

Know your out-of-pocket cost for care.

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