St. Barnabas Hospital

All Charges

Charge

Type

Price

CATHETER RECTAL 42CM

Facility OP

$384.00

Hospital Charge Code	40201055
Hospital Revenue Code	270
Min. Negotiated Rate	$134.40
Max. Negotiated Rate	$307.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$211.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$192.00
Rate for Payer: Aetna Government	$192.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$307.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$261.12
Rate for Payer: Group Health Inc Commercial	$192.00
Rate for Payer: Group Health Inc Medicare	$134.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$192.00
Rate for Payer: Hamaspik Choice Inc Medicare	$192.00

CATHETER RED RUBBER 14FR

Facility OP

$0.85

Hospital Charge Code	64904230
Hospital Revenue Code	279
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.43
Rate for Payer: Aetna Government	$0.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.58
Rate for Payer: Group Health Inc Commercial	$0.43
Rate for Payer: Group Health Inc Medicare	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43
Rate for Payer: Hamaspik Choice Inc Medicare	$0.43

CATHETER RED RUBBER 14FR

Facility OP

$118.00

Hospital Charge Code	40201056
Hospital Revenue Code	270
Min. Negotiated Rate	$41.30
Max. Negotiated Rate	$94.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$64.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$59.00
Rate for Payer: Aetna Government	$59.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$94.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$80.24
Rate for Payer: Group Health Inc Commercial	$59.00
Rate for Payer: Group Health Inc Medicare	$41.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.00
Rate for Payer: Hamaspik Choice Inc Medicare	$59.00

CATHETER RED RUBBER 16FR

Facility OP

$118.00

Hospital Charge Code	40201057
Hospital Revenue Code	270
Min. Negotiated Rate	$41.30
Max. Negotiated Rate	$94.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$64.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$59.00
Rate for Payer: Aetna Government	$59.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$94.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$80.24
Rate for Payer: Group Health Inc Commercial	$59.00
Rate for Payer: Group Health Inc Medicare	$41.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.00
Rate for Payer: Hamaspik Choice Inc Medicare	$59.00

CATHETER RED RUBBER 16FR

Facility OP

$0.85

Hospital Charge Code	64904232
Hospital Revenue Code	279
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.43
Rate for Payer: Aetna Government	$0.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.58
Rate for Payer: Group Health Inc Commercial	$0.43
Rate for Payer: Group Health Inc Medicare	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43
Rate for Payer: Hamaspik Choice Inc Medicare	$0.43

CATHETER RED RUBBER 18FR

Facility OP

$0.85

Hospital Charge Code	64904514
Hospital Revenue Code	279
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.43
Rate for Payer: Aetna Government	$0.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.58
Rate for Payer: Group Health Inc Commercial	$0.43
Rate for Payer: Group Health Inc Medicare	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43
Rate for Payer: Hamaspik Choice Inc Medicare	$0.43

CATHETERS #1055

Facility OP

$17.01

Hospital Charge Code	40200914
Hospital Revenue Code	270
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$13.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.50
Rate for Payer: Aetna Government	$8.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.57
Rate for Payer: Group Health Inc Commercial	$8.50
Rate for Payer: Group Health Inc Medicare	$5.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.50
Rate for Payer: Hamaspik Choice Inc Medicare	$8.50

CATHETERS #1059

Facility OP

$17.01

Hospital Charge Code	40200916
Hospital Revenue Code	270
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$13.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.50
Rate for Payer: Aetna Government	$8.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.57
Rate for Payer: Group Health Inc Commercial	$8.50
Rate for Payer: Group Health Inc Medicare	$5.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.50
Rate for Payer: Hamaspik Choice Inc Medicare	$8.50

CATHETERS #1061

Facility OP

$17.01

Hospital Charge Code	40200917
Hospital Revenue Code	270
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$13.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.50
Rate for Payer: Aetna Government	$8.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.57
Rate for Payer: Group Health Inc Commercial	$8.50
Rate for Payer: Group Health Inc Medicare	$5.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.50
Rate for Payer: Hamaspik Choice Inc Medicare	$8.50

CATHETERS #1550

Facility OP

$6.73

Hospital Charge Code	40200913
Hospital Revenue Code	270
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.36
Rate for Payer: Aetna Government	$3.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.36
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.36
Rate for Payer: Hamaspik Choice Inc Medicare	$3.36

CATHETERS #1556

Facility OP

$12.05

Hospital Charge Code	40200915
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$9.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.02
Rate for Payer: Aetna Government	$6.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.19
Rate for Payer: Group Health Inc Commercial	$6.02
Rate for Payer: Group Health Inc Medicare	$4.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.02
Rate for Payer: Hamaspik Choice Inc Medicare	$6.02

CATHETER TENCKHOFF CUFF 42CM

Facility OP

$178.45

Hospital Charge Code	64904917
Hospital Revenue Code	279
Min. Negotiated Rate	$62.46
Max. Negotiated Rate	$142.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$89.22
Rate for Payer: Aetna Government	$89.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$121.35
Rate for Payer: Group Health Inc Commercial	$89.22
Rate for Payer: Group Health Inc Medicare	$62.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.22
Rate for Payer: Hamaspik Choice Inc Medicare	$89.22

CATHETER TENCKHOFF PERITONEAL

Facility OP

$106.00

Hospital Charge Code	40201058
Hospital Revenue Code	270
Min. Negotiated Rate	$37.10
Max. Negotiated Rate	$84.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$53.00
Rate for Payer: Aetna Government	$53.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$84.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$72.08
Rate for Payer: Group Health Inc Commercial	$53.00
Rate for Payer: Group Health Inc Medicare	$37.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.00
Rate for Payer: Hamaspik Choice Inc Medicare	$53.00

CATHETER,THORACIC,ST,A,32FR

Facility OP

$13.11

Hospital Charge Code	64902048
Hospital Revenue Code	279
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$10.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.56
Rate for Payer: Aetna Government	$6.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.91
Rate for Payer: Group Health Inc Commercial	$6.56
Rate for Payer: Group Health Inc Medicare	$4.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.56
Rate for Payer: Hamaspik Choice Inc Medicare	$6.56

CATHETER THROMBECTOMY 4F INTIMAX

Facility OP

$291.48

Hospital Charge Code	64902695
Hospital Revenue Code	279
Min. Negotiated Rate	$102.02
Max. Negotiated Rate	$233.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$160.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$145.74
Rate for Payer: Aetna Government	$145.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$233.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$198.21
Rate for Payer: Group Health Inc Commercial	$145.74
Rate for Payer: Group Health Inc Medicare	$102.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$145.74
Rate for Payer: Hamaspik Choice Inc Medicare	$145.74

CATHETER TRACH CARE 14F

Facility OP

$750.00

Hospital Charge Code	64901995
Hospital Revenue Code	279
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$412.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$375.00
Rate for Payer: Aetna Government	$375.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$510.00
Rate for Payer: Group Health Inc Commercial	$375.00
Rate for Payer: Group Health Inc Medicare	$262.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$375.00
Rate for Payer: Hamaspik Choice Inc Medicare	$375.00

CATHETER TRI-LOBE BALLOON

Facility OP

$1,815.00

Service Code	HCPCS C1874
Hospital Charge Code	64907418
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$1,905.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$998.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$907.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,043.62
Rate for Payer: Fidelis Medicare Advantage	$1,905.75
Rate for Payer: Group Health Inc Commercial	$907.50
Rate for Payer: Group Health Inc Medicare	$635.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$907.50
Rate for Payer: Hamaspik Choice Inc Medicare	$907.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,179.75

CATHETER TRI-LOBE BALLOON

Facility IP

$1,815.00

Service Code	HCPCS C1874
Hospital Charge Code	64907418
Hospital Revenue Code	278
Min. Negotiated Rate	$907.50
Max. Negotiated Rate	$907.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$907.50
Rate for Payer: Hamaspik Choice Inc Medicare	$907.50

CATHETER UMBILICAL 3.5FR URETHANE

Facility OP

$368.83

Hospital Charge Code	64902855
Hospital Revenue Code	279
Min. Negotiated Rate	$129.09
Max. Negotiated Rate	$295.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$184.42
Rate for Payer: Aetna Government	$184.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$295.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$250.80
Rate for Payer: Group Health Inc Commercial	$184.42
Rate for Payer: Group Health Inc Medicare	$129.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.42
Rate for Payer: Hamaspik Choice Inc Medicare	$184.42

CATHETER VASCULAR

Facility IP

$357.37

Service Code	HCPCS C1768
Hospital Charge Code	40204089
Hospital Revenue Code	278
Min. Negotiated Rate	$178.68
Max. Negotiated Rate	$178.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.68
Rate for Payer: Hamaspik Choice Inc Medicare	$178.68

CATHETER VASCULAR

Facility OP

$357.37

Service Code	HCPCS C1768
Hospital Charge Code	40204089
Hospital Revenue Code	278
Min. Negotiated Rate	$125.08
Max. Negotiated Rate	$375.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$196.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$322.77
Rate for Payer: Aetna Government	$322.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$178.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$205.49
Rate for Payer: Fidelis Medicare Advantage	$375.24
Rate for Payer: Group Health Inc Commercial	$178.68
Rate for Payer: Group Health Inc Medicare	$125.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.68
Rate for Payer: Hamaspik Choice Inc Medicare	$178.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$232.29

CATHETER W/LOADER 2.6MM

Facility OP

$2,000.00

Service Code	HCPCS C1726
Hospital Charge Code	64906891
Hospital Revenue Code	278
Min. Negotiated Rate	$17.43
Max. Negotiated Rate	$2,100.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.43
Rate for Payer: Aetna Government	$17.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,150.00
Rate for Payer: Fidelis Medicare Advantage	$2,100.00
Rate for Payer: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,300.00

CATHETER W/LOADER 2.6MM

Facility IP

$2,000.00

Service Code	HCPCS C1726
Hospital Charge Code	64906891
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

CATHETER WORD BARTHOLIN 10FR

Facility OP

$77.46

Hospital Charge Code	64902821
Hospital Revenue Code	279
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$61.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$42.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$38.73
Rate for Payer: Aetna Government	$38.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$61.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$52.67
Rate for Payer: Group Health Inc Commercial	$38.73
Rate for Payer: Group Health Inc Medicare	$27.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.73
Rate for Payer: Hamaspik Choice Inc Medicare	$38.73

CATH EVRCR 035 7X100 80CM

Facility IP

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	64906810
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$345.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$345.00
Rate for Payer: Hamaspik Choice Inc Medicare	$345.00

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