St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ INFUSION CATH/FASTRACKER-18

Facility

$627.25

Service Code	HCPCS C1725
Hospital Charge Code	41569517
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$658.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$344.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$376.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$313.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.67
Rate for Payer: EmblemHealth Commercial	$313.62
Rate for Payer: Fidelis Medicare Advantage	$658.61
Rate for Payer: Group Health Inc Commercial	$313.62
Rate for Payer: Group Health Inc Medicare	$219.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.62
Rate for Payer: Hamaspik Choice Inc Medicare	$313.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$407.71

ZZ INTERLOCK 2D OCCLU. SYST.

Facility

$794.00

Hospital Charge Code	41569962
Hospital Revenue Code	279
Min. Negotiated Rate	$277.90
Max. Negotiated Rate	$635.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$436.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$397.00
Rate for Payer: Aetna Government	$397.00
Rate for Payer: Brighton Health Commercial	$595.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$635.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$539.92
Rate for Payer: Group Health Inc Commercial	$397.00
Rate for Payer: Group Health Inc Medicare	$277.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$397.00
Rate for Payer: Hamaspik Choice Inc Medicare	$397.00

ZZ INTRACOIL STENT

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41560055
Hospital Revenue Code	278
Min. Negotiated Rate	$1,701.00
Max. Negotiated Rate	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00

ZZ INTRACOIL STENT

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41560055
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,572.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,871.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,041.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,701.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,956.15
Rate for Payer: EmblemHealth Commercial	$1,701.00
Rate for Payer: Fidelis Medicare Advantage	$3,572.10
Rate for Payer: Group Health Inc Commercial	$1,701.00
Rate for Payer: Group Health Inc Medicare	$1,190.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,211.30

ZZ INTRACOIL STENT 4X40

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569660
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,572.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,871.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,041.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,701.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,956.15
Rate for Payer: EmblemHealth Commercial	$1,701.00
Rate for Payer: Fidelis Medicare Advantage	$3,572.10
Rate for Payer: Group Health Inc Commercial	$1,701.00
Rate for Payer: Group Health Inc Medicare	$1,190.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,211.30

ZZ INTRACOIL STENT 4X40

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569660
Hospital Revenue Code	278
Min. Negotiated Rate	$1,701.00
Max. Negotiated Rate	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00

ZZ INTRACOIL STENT 5X40

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569658
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,572.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,871.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,041.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,701.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,956.15
Rate for Payer: EmblemHealth Commercial	$1,701.00
Rate for Payer: Fidelis Medicare Advantage	$3,572.10
Rate for Payer: Group Health Inc Commercial	$1,701.00
Rate for Payer: Group Health Inc Medicare	$1,190.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,211.30

ZZ INTRACOIL STENT 5X40

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569658
Hospital Revenue Code	278
Min. Negotiated Rate	$1,701.00
Max. Negotiated Rate	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00

ZZ INTRACOIL STENT 5X60

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569661
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,572.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,871.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,041.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,701.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,956.15
Rate for Payer: EmblemHealth Commercial	$1,701.00
Rate for Payer: Fidelis Medicare Advantage	$3,572.10
Rate for Payer: Group Health Inc Commercial	$1,701.00
Rate for Payer: Group Health Inc Medicare	$1,190.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,211.30

ZZ INTRACOIL STENT 5X60

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,701.00
Max. Negotiated Rate	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00

ZZ INTRACOIL STENT 6X40

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569662
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,572.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,871.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,041.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,701.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,956.15
Rate for Payer: EmblemHealth Commercial	$1,701.00
Rate for Payer: Fidelis Medicare Advantage	$3,572.10
Rate for Payer: Group Health Inc Commercial	$1,701.00
Rate for Payer: Group Health Inc Medicare	$1,190.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,211.30

ZZ INTRACOIL STENT 6X40

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569662
Hospital Revenue Code	278
Min. Negotiated Rate	$1,701.00
Max. Negotiated Rate	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00

ZZ INTRACOIL STENT 6X60

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569659
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,572.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,871.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,041.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,701.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,956.15
Rate for Payer: EmblemHealth Commercial	$1,701.00
Rate for Payer: Fidelis Medicare Advantage	$3,572.10
Rate for Payer: Group Health Inc Commercial	$1,701.00
Rate for Payer: Group Health Inc Medicare	$1,190.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,211.30

ZZ INTRACOIL STENT 6X60

Facility

$3,402.00

Service Code	HCPCS C1876
Hospital Charge Code	41569659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,701.00
Max. Negotiated Rate	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,701.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,701.00

ZZ INTRASTENT DOUBLE STENT

Facility

$3,827.25

Service Code	HCPCS C1876
Hospital Charge Code	41569543
Hospital Revenue Code	278
Min. Negotiated Rate	$1,913.62
Max. Negotiated Rate	$1,913.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,913.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,913.62

ZZ INTRASTENT DOUBLE STENT

Facility

$3,827.25

Service Code	HCPCS C1876
Hospital Charge Code	41569543
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,018.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,104.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,296.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,913.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,200.67
Rate for Payer: EmblemHealth Commercial	$1,913.62
Rate for Payer: Fidelis Medicare Advantage	$4,018.61
Rate for Payer: Group Health Inc Commercial	$1,913.62
Rate for Payer: Group Health Inc Medicare	$1,339.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,913.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,913.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,487.71

ZZ INTRA STENT #S10 26 26MM

Facility

$1,828.58

Service Code	HCPCS C1876
Hospital Charge Code	41569014
Hospital Revenue Code	278
Min. Negotiated Rate	$914.29
Max. Negotiated Rate	$914.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$914.29
Rate for Payer: Hamaspik Choice Inc Medicare	$914.29

ZZ INTRA STENT #S10 26 26MM

Facility

$1,828.58

Service Code	HCPCS C1876
Hospital Charge Code	41569014
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,920.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,005.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,097.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$914.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,051.43
Rate for Payer: EmblemHealth Commercial	$914.29
Rate for Payer: Fidelis Medicare Advantage	$1,920.01
Rate for Payer: Group Health Inc Commercial	$914.29
Rate for Payer: Group Health Inc Medicare	$640.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$914.29
Rate for Payer: Hamaspik Choice Inc Medicare	$914.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,188.58

ZZ INTRA STENT #S10 36 36MM

Facility

$1,828.58

Service Code	HCPCS C1876
Hospital Charge Code	41569013
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,920.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,005.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,097.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$914.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,051.43
Rate for Payer: EmblemHealth Commercial	$914.29
Rate for Payer: Fidelis Medicare Advantage	$1,920.01
Rate for Payer: Group Health Inc Commercial	$914.29
Rate for Payer: Group Health Inc Medicare	$640.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$914.29
Rate for Payer: Hamaspik Choice Inc Medicare	$914.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,188.58

ZZ INTRA STENT #S10 36 36MM

Facility

$1,828.58

Service Code	HCPCS C1876
Hospital Charge Code	41569013
Hospital Revenue Code	278
Min. Negotiated Rate	$914.29
Max. Negotiated Rate	$914.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$914.29
Rate for Payer: Hamaspik Choice Inc Medicare	$914.29

ZZ INTRATERINE ACESS BALLOON CATH

Facility

$102.78

Service Code	HCPCS C1726
Hospital Charge Code	41567756
Hospital Revenue Code	278
Min. Negotiated Rate	$51.39
Max. Negotiated Rate	$51.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.39
Rate for Payer: Hamaspik Choice Inc Medicare	$51.39

ZZ INTRATERINE ACESS BALLOON CATH

Facility

$102.78

Service Code	HCPCS C1726
Hospital Charge Code	41567756
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$107.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Brighton Health Commercial	$61.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.10
Rate for Payer: EmblemHealth Commercial	$51.39
Rate for Payer: Fidelis Medicare Advantage	$107.92
Rate for Payer: Group Health Inc Commercial	$51.39
Rate for Payer: Group Health Inc Medicare	$35.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.39
Rate for Payer: Hamaspik Choice Inc Medicare	$51.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.81

ZZ INTRODUCER FLEXOR 5FR X 4

Facility

$165.30

Hospital Charge Code	41564478
Hospital Revenue Code	270
Min. Negotiated Rate	$57.86
Max. Negotiated Rate	$132.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$82.65
Rate for Payer: Aetna Government	$82.65
Rate for Payer: Brighton Health Commercial	$123.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$132.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.40
Rate for Payer: Group Health Inc Commercial	$82.65
Rate for Payer: Group Health Inc Medicare	$57.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.65
Rate for Payer: Hamaspik Choice Inc Medicare	$82.65

ZZ INTRODUCER SET ANSEL 6FR 55CM

Facility

$197.03

Hospital Charge Code	41569676
Hospital Revenue Code	270
Min. Negotiated Rate	$68.96
Max. Negotiated Rate	$157.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$108.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.52
Rate for Payer: Aetna Government	$98.52
Rate for Payer: Brighton Health Commercial	$147.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$157.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$133.98
Rate for Payer: Group Health Inc Commercial	$98.52
Rate for Payer: Group Health Inc Medicare	$68.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.52
Rate for Payer: Hamaspik Choice Inc Medicare	$98.52

ZZ INTRO SET 10.0/30CM G08686

Facility

$136.62

Service Code	HCPCS C1894
Hospital Charge Code	41569944
Hospital Revenue Code	278
Min. Negotiated Rate	$68.31
Max. Negotiated Rate	$68.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.31
Rate for Payer: Hamaspik Choice Inc Medicare	$68.31

Know your out-of-pocket cost for care.

All Charges