St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ INT SH W/O NDL 8.5 38

Facility

$51.39

Hospital Charge Code	41567037
Hospital Revenue Code	270
Min. Negotiated Rate	$17.99
Max. Negotiated Rate	$41.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.70
Rate for Payer: Aetna Government	$25.70
Rate for Payer: Brighton Health Commercial	$38.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.95
Rate for Payer: Group Health Inc Commercial	$25.70
Rate for Payer: Group Health Inc Medicare	$17.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.70
Rate for Payer: Hamaspik Choice Inc Medicare	$25.70

ZZ ISOVUE 300 100ML

Facility

$63.70

Service Code	HCPCS Q9967
Hospital Charge Code	41567530
Hospital Revenue Code	255
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$50.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Brighton Health Commercial	$47.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.32
Rate for Payer: Group Health Inc Commercial	$31.85
Rate for Payer: Group Health Inc Medicare	$22.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.85
Rate for Payer: Hamaspik Choice Inc Medicare	$31.85
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.14
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.15
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.15
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$41.40

ZZ ISOVUE 300 150ML

Facility

$92.85

Service Code	HCPCS Q9967
Hospital Charge Code	41567531
Hospital Revenue Code	255
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$74.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Brighton Health Commercial	$69.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$74.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.14
Rate for Payer: Group Health Inc Commercial	$46.42
Rate for Payer: Group Health Inc Medicare	$32.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$46.42
Rate for Payer: Hamaspik Choice Inc Medicare	$46.42
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.14
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.15
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.15
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$60.35

ZZ ISOVUE 300 50ML

Facility

$32.60

Hospital Charge Code	41567528
Hospital Revenue Code	270
Min. Negotiated Rate	$11.41
Max. Negotiated Rate	$26.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.30
Rate for Payer: Aetna Government	$16.30
Rate for Payer: Brighton Health Commercial	$24.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.17
Rate for Payer: Group Health Inc Commercial	$16.30
Rate for Payer: Group Health Inc Medicare	$11.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.30
Rate for Payer: Hamaspik Choice Inc Medicare	$16.30

ZZ ISOVUE 300 75ML

Facility

$50.33

Hospital Charge Code	41567529
Hospital Revenue Code	270
Min. Negotiated Rate	$17.62
Max. Negotiated Rate	$40.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.16
Rate for Payer: Aetna Government	$25.16
Rate for Payer: Brighton Health Commercial	$37.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.22
Rate for Payer: Group Health Inc Commercial	$25.16
Rate for Payer: Group Health Inc Medicare	$17.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.16
Rate for Payer: Hamaspik Choice Inc Medicare	$25.16

ZZ ISOVUE-M-200 20ML

Facility

$41.82

Hospital Charge Code	41567526
Hospital Revenue Code	270
Min. Negotiated Rate	$14.64
Max. Negotiated Rate	$33.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.91
Rate for Payer: Aetna Government	$20.91
Rate for Payer: Brighton Health Commercial	$31.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.44
Rate for Payer: Group Health Inc Commercial	$20.91
Rate for Payer: Group Health Inc Medicare	$14.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.91
Rate for Payer: Hamaspik Choice Inc Medicare	$20.91

ZZ IVALON PRTCLS 710-1000

Facility

$277.13

Hospital Charge Code	41567304
Hospital Revenue Code	270
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$221.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$138.56
Rate for Payer: Aetna Government	$138.56
Rate for Payer: Brighton Health Commercial	$207.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$221.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.45
Rate for Payer: Group Health Inc Commercial	$138.56
Rate for Payer: Group Health Inc Medicare	$97.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.56
Rate for Payer: Hamaspik Choice Inc Medicare	$138.56

ZZ IVALON PTCLES 355-500

Facility

$277.13

Hospital Charge Code	41567303
Hospital Revenue Code	270
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$221.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$138.56
Rate for Payer: Aetna Government	$138.56
Rate for Payer: Brighton Health Commercial	$207.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$221.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.45
Rate for Payer: Group Health Inc Commercial	$138.56
Rate for Payer: Group Health Inc Medicare	$97.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.56
Rate for Payer: Hamaspik Choice Inc Medicare	$138.56

ZZ IVC FILTER (BARD) FEMORAL ECLY

Facility

$3,118.00

Hospital Charge Code	40207739
Hospital Revenue Code	270
Min. Negotiated Rate	$1,091.30
Max. Negotiated Rate	$2,494.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,714.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,559.00
Rate for Payer: Aetna Government	$1,559.00
Rate for Payer: Brighton Health Commercial	$2,338.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,494.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,120.24
Rate for Payer: Group Health Inc Commercial	$1,559.00
Rate for Payer: Group Health Inc Medicare	$1,091.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,559.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,559.00

ZZ IVC FILTER (BARD) FEMORAL ECLY

Facility

$3,118.00

Hospital Charge Code	41567739
Hospital Revenue Code	270
Min. Negotiated Rate	$1,091.30
Max. Negotiated Rate	$2,494.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,714.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,559.00
Rate for Payer: Aetna Government	$1,559.00
Rate for Payer: Brighton Health Commercial	$2,338.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,494.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,120.24
Rate for Payer: Group Health Inc Commercial	$1,559.00
Rate for Payer: Group Health Inc Medicare	$1,091.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,559.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,559.00

ZZ IVC FILTER (BARD) JUGULAR ECLY

Facility

$3,118.00

Hospital Charge Code	41567740
Hospital Revenue Code	270
Min. Negotiated Rate	$1,091.30
Max. Negotiated Rate	$2,494.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,714.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,559.00
Rate for Payer: Aetna Government	$1,559.00
Rate for Payer: Brighton Health Commercial	$2,338.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,494.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,120.24
Rate for Payer: Group Health Inc Commercial	$1,559.00
Rate for Payer: Group Health Inc Medicare	$1,091.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,559.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,559.00

ZZ IVC FILTER FEMORAL(GUNTHER TUL

Facility

$3,124.17

Service Code	HCPCS C1880
Hospital Charge Code	41569802
Hospital Revenue Code	278
Min. Negotiated Rate	$1,562.08
Max. Negotiated Rate	$1,562.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,562.08
Rate for Payer: Hamaspik Choice Inc Medicare	$1,562.08

ZZ IVC FILTER FEMORAL(GUNTHER TUL

Facility

$3,124.17

Service Code	HCPCS C1880
Hospital Charge Code	41569802
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$3,280.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,718.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Brighton Health Commercial	$1,874.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,562.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,796.40
Rate for Payer: EmblemHealth Commercial	$1,562.08
Rate for Payer: Fidelis Medicare Advantage	$3,280.38
Rate for Payer: Group Health Inc Commercial	$1,562.08
Rate for Payer: Group Health Inc Medicare	$1,093.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,562.08
Rate for Payer: Hamaspik Choice Inc Medicare	$1,562.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,030.71

ZZ IVC FILTER JUGULAR(GUNTHER TUL

Facility

$3,124.17

Service Code	HCPCS C1880
Hospital Charge Code	41569803
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$3,280.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,718.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Brighton Health Commercial	$1,874.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,562.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,796.40
Rate for Payer: EmblemHealth Commercial	$1,562.08
Rate for Payer: Fidelis Medicare Advantage	$3,280.38
Rate for Payer: Group Health Inc Commercial	$1,562.08
Rate for Payer: Group Health Inc Medicare	$1,093.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,562.08
Rate for Payer: Hamaspik Choice Inc Medicare	$1,562.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,030.71

ZZ IVC FILTER JUGULAR(GUNTHER TUL

Facility

$3,124.17

Service Code	HCPCS C1880
Hospital Charge Code	41569803
Hospital Revenue Code	278
Min. Negotiated Rate	$1,562.08
Max. Negotiated Rate	$1,562.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,562.08
Rate for Payer: Hamaspik Choice Inc Medicare	$1,562.08

ZZ JACKSON PRATT 100M #SH130 1305

Facility

$98.24

Hospital Charge Code	41569035
Hospital Revenue Code	270
Min. Negotiated Rate	$34.38
Max. Negotiated Rate	$78.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$54.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$49.12
Rate for Payer: Aetna Government	$49.12
Rate for Payer: Brighton Health Commercial	$73.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$78.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.80
Rate for Payer: Group Health Inc Commercial	$49.12
Rate for Payer: Group Health Inc Medicare	$34.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.12
Rate for Payer: Hamaspik Choice Inc Medicare	$49.12

ZZ J & J CLINCHER ANOT DEVICE

Facility

$56.70

Hospital Charge Code	41569536
Hospital Revenue Code	270
Min. Negotiated Rate	$19.84
Max. Negotiated Rate	$45.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.35
Rate for Payer: Aetna Government	$28.35
Rate for Payer: Brighton Health Commercial	$42.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.56
Rate for Payer: Group Health Inc Commercial	$28.35
Rate for Payer: Group Health Inc Medicare	$19.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.35
Rate for Payer: Hamaspik Choice Inc Medicare	$28.35

ZZ J & J CLISER PERCLOSE

Facility

$637.88

Hospital Charge Code	41569535
Hospital Revenue Code	270
Min. Negotiated Rate	$223.26
Max. Negotiated Rate	$510.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$350.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$318.94
Rate for Payer: Aetna Government	$318.94
Rate for Payer: Brighton Health Commercial	$478.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$510.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$433.76
Rate for Payer: Group Health Inc Commercial	$318.94
Rate for Payer: Group Health Inc Medicare	$223.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$318.94
Rate for Payer: Hamaspik Choice Inc Medicare	$318.94

ZZ J & J SUARES ANOT PUSHER

Facility

$56.70

Hospital Charge Code	41569537
Hospital Revenue Code	270
Min. Negotiated Rate	$19.84
Max. Negotiated Rate	$45.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.35
Rate for Payer: Aetna Government	$28.35
Rate for Payer: Brighton Health Commercial	$42.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.56
Rate for Payer: Group Health Inc Commercial	$28.35
Rate for Payer: Group Health Inc Medicare	$19.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.35
Rate for Payer: Hamaspik Choice Inc Medicare	$28.35

ZZ J TIP 10/25

Facility

$257.63

Hospital Charge Code	41567231
Hospital Revenue Code	270
Min. Negotiated Rate	$90.17
Max. Negotiated Rate	$206.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$141.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$128.82
Rate for Payer: Aetna Government	$128.82
Rate for Payer: Brighton Health Commercial	$193.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$175.19
Rate for Payer: Group Health Inc Commercial	$128.82
Rate for Payer: Group Health Inc Medicare	$90.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.82
Rate for Payer: Hamaspik Choice Inc Medicare	$128.82

ZZ J TIP 8/25 LOOP

Facility

$257.63

Hospital Charge Code	41567232
Hospital Revenue Code	270
Min. Negotiated Rate	$90.17
Max. Negotiated Rate	$206.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$141.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$128.82
Rate for Payer: Aetna Government	$128.82
Rate for Payer: Brighton Health Commercial	$193.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$175.19
Rate for Payer: Group Health Inc Commercial	$128.82
Rate for Payer: Group Health Inc Medicare	$90.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.82
Rate for Payer: Hamaspik Choice Inc Medicare	$128.82

ZZ J WIRES 35-145-1.5 BH

Facility

$37.92

Hospital Charge Code	41567105
Hospital Revenue Code	270
Min. Negotiated Rate	$13.27
Max. Negotiated Rate	$30.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.96
Rate for Payer: Aetna Government	$18.96
Rate for Payer: Brighton Health Commercial	$28.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.79
Rate for Payer: Group Health Inc Commercial	$18.96
Rate for Payer: Group Health Inc Medicare	$13.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.96
Rate for Payer: Hamaspik Choice Inc Medicare	$18.96

ZZ J WIRES 35-145-15 BH

Facility

$37.92

Hospital Charge Code	41567104
Hospital Revenue Code	270
Min. Negotiated Rate	$13.27
Max. Negotiated Rate	$30.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.96
Rate for Payer: Aetna Government	$18.96
Rate for Payer: Brighton Health Commercial	$28.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.79
Rate for Payer: Group Health Inc Commercial	$18.96
Rate for Payer: Group Health Inc Medicare	$13.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.96
Rate for Payer: Hamaspik Choice Inc Medicare	$18.96

ZZ J WIRES 35-145-3 BH

Facility

$37.92

Hospital Charge Code	41567106
Hospital Revenue Code	270
Min. Negotiated Rate	$13.27
Max. Negotiated Rate	$30.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.96
Rate for Payer: Aetna Government	$18.96
Rate for Payer: Brighton Health Commercial	$28.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.79
Rate for Payer: Group Health Inc Commercial	$18.96
Rate for Payer: Group Health Inc Medicare	$13.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.96
Rate for Payer: Hamaspik Choice Inc Medicare	$18.96

ZZ J WIRES 35-145 BH

Facility

$30.83

Hospital Charge Code	41567103
Hospital Revenue Code	270
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$24.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.42
Rate for Payer: Aetna Government	$15.42
Rate for Payer: Brighton Health Commercial	$23.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.96
Rate for Payer: Group Health Inc Commercial	$15.42
Rate for Payer: Group Health Inc Medicare	$10.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.42
Rate for Payer: Hamaspik Choice Inc Medicare	$15.42

Know your out-of-pocket cost for care.

All Charges