St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ KATZEN CORE WIRE

Facility

$75.13

Hospital Charge Code	41567255
Hospital Revenue Code	270
Min. Negotiated Rate	$26.30
Max. Negotiated Rate	$60.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.56
Rate for Payer: Aetna Government	$37.56
Rate for Payer: Brighton Health Commercial	$56.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.09
Rate for Payer: Group Health Inc Commercial	$37.56
Rate for Payer: Group Health Inc Medicare	$26.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.56
Rate for Payer: Hamaspik Choice Inc Medicare	$37.56

ZZ KATZEN INF WIRES 35/3

Facility

$570.55

Hospital Charge Code	41567252
Hospital Revenue Code	270
Min. Negotiated Rate	$199.69
Max. Negotiated Rate	$456.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$313.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$285.28
Rate for Payer: Aetna Government	$285.28
Rate for Payer: Brighton Health Commercial	$427.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$387.97
Rate for Payer: Group Health Inc Commercial	$285.28
Rate for Payer: Group Health Inc Medicare	$199.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$285.28
Rate for Payer: Hamaspik Choice Inc Medicare	$285.28

ZZ KATZEN INF WIRES 35/6

Facility

$570.55

Hospital Charge Code	41567253
Hospital Revenue Code	270
Min. Negotiated Rate	$199.69
Max. Negotiated Rate	$456.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$313.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$285.28
Rate for Payer: Aetna Government	$285.28
Rate for Payer: Brighton Health Commercial	$427.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$387.97
Rate for Payer: Group Health Inc Commercial	$285.28
Rate for Payer: Group Health Inc Medicare	$199.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$285.28
Rate for Payer: Hamaspik Choice Inc Medicare	$285.28

ZZ KATZEN INF WIRES 35/9

Facility

$570.55

Hospital Charge Code	41567254
Hospital Revenue Code	270
Min. Negotiated Rate	$199.69
Max. Negotiated Rate	$456.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$313.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$285.28
Rate for Payer: Aetna Government	$285.28
Rate for Payer: Brighton Health Commercial	$427.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$387.97
Rate for Payer: Group Health Inc Commercial	$285.28
Rate for Payer: Group Health Inc Medicare	$199.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$285.28
Rate for Payer: Hamaspik Choice Inc Medicare	$285.28

ZZ KC GASTROSTOMY FEEDING TUBE

Facility

$66.28

Hospital Charge Code	41561900
Hospital Revenue Code	270
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$53.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.14
Rate for Payer: Aetna Government	$33.14
Rate for Payer: Brighton Health Commercial	$49.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.07
Rate for Payer: Group Health Inc Commercial	$33.14
Rate for Payer: Group Health Inc Medicare	$23.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.14
Rate for Payer: Hamaspik Choice Inc Medicare	$33.14

ZZ KC GASTROSTOMY FEEDING TUBE

Facility

$66.28

Hospital Charge Code	30301900
Hospital Revenue Code	270
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$53.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.14
Rate for Payer: Aetna Government	$33.14
Rate for Payer: Brighton Health Commercial	$49.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.07
Rate for Payer: Group Health Inc Commercial	$33.14
Rate for Payer: Group Health Inc Medicare	$23.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.14
Rate for Payer: Hamaspik Choice Inc Medicare	$33.14

ZZ KC TRANSGASTRIC FEEDING KIT

Facility

$66.28

Hospital Charge Code	41561901
Hospital Revenue Code	270
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$53.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.14
Rate for Payer: Aetna Government	$33.14
Rate for Payer: Brighton Health Commercial	$49.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.07
Rate for Payer: Group Health Inc Commercial	$33.14
Rate for Payer: Group Health Inc Medicare	$23.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.14
Rate for Payer: Hamaspik Choice Inc Medicare	$33.14

ZZ KIT INTRO SURG 6 FR 150 20

Facility

$187.50

Hospital Charge Code	41568091
Hospital Revenue Code	270
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$103.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$93.75
Rate for Payer: Aetna Government	$93.75
Rate for Payer: Brighton Health Commercial	$140.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.50
Rate for Payer: Group Health Inc Commercial	$93.75
Rate for Payer: Group Health Inc Medicare	$65.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.75
Rate for Payer: Hamaspik Choice Inc Medicare	$93.75

ZZ KIT MIDLINE 2 LMN 5.5F

Facility

$397.50

Hospital Charge Code	41568092
Hospital Revenue Code	270
Min. Negotiated Rate	$139.12
Max. Negotiated Rate	$318.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$218.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$198.75
Rate for Payer: Aetna Government	$198.75
Rate for Payer: Brighton Health Commercial	$298.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$318.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$270.30
Rate for Payer: Group Health Inc Commercial	$198.75
Rate for Payer: Group Health Inc Medicare	$139.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$198.75
Rate for Payer: Hamaspik Choice Inc Medicare	$198.75

ZZ KIT NEEDLE MISSION 18GX

Facility

$123.61

Hospital Charge Code	41568094
Hospital Revenue Code	270
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$98.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$61.80
Rate for Payer: Aetna Government	$61.80
Rate for Payer: Brighton Health Commercial	$92.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$98.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.05
Rate for Payer: Group Health Inc Commercial	$61.80
Rate for Payer: Group Health Inc Medicare	$43.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.80
Rate for Payer: Hamaspik Choice Inc Medicare	$61.80

ZZ KIT NEEDLE MISSION 20GX

Facility

$126.12

Hospital Charge Code	41568095
Hospital Revenue Code	270
Min. Negotiated Rate	$44.14
Max. Negotiated Rate	$100.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.06
Rate for Payer: Aetna Government	$63.06
Rate for Payer: Brighton Health Commercial	$94.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.76
Rate for Payer: Group Health Inc Commercial	$63.06
Rate for Payer: Group Health Inc Medicare	$44.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.06
Rate for Payer: Hamaspik Choice Inc Medicare	$63.06

ZZ LATEX PROBE COVER

Facility

$6.38

Hospital Charge Code	41567291
Hospital Revenue Code	270
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$5.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.19
Rate for Payer: Aetna Government	$3.19
Rate for Payer: Brighton Health Commercial	$4.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.34
Rate for Payer: Group Health Inc Commercial	$3.19
Rate for Payer: Group Health Inc Medicare	$2.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.19
Rate for Payer: Hamaspik Choice Inc Medicare	$3.19

ZZ LEVEEN COACC ELEC 3.0/15/15

Facility

$1,950.00

Hospital Charge Code	41568517
Hospital Revenue Code	270
Min. Negotiated Rate	$682.50
Max. Negotiated Rate	$1,560.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,072.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$975.00
Rate for Payer: Aetna Government	$975.00
Rate for Payer: Brighton Health Commercial	$1,462.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,560.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,326.00
Rate for Payer: Group Health Inc Commercial	$975.00
Rate for Payer: Group Health Inc Medicare	$682.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$975.00
Rate for Payer: Hamaspik Choice Inc Medicare	$975.00

ZZ LEVEEN COACC ELEC 3.5/15/15

Facility

$2,300.00

Hospital Charge Code	41568518
Hospital Revenue Code	270
Min. Negotiated Rate	$805.00
Max. Negotiated Rate	$1,840.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,265.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,150.00
Rate for Payer: Aetna Government	$1,150.00
Rate for Payer: Brighton Health Commercial	$1,725.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,840.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,564.00
Rate for Payer: Group Health Inc Commercial	$1,150.00
Rate for Payer: Group Health Inc Medicare	$805.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,150.00

ZZ LEVEEN COACC ELEC 4.0/15/15

Facility

$2,700.00

Hospital Charge Code	41568519
Hospital Revenue Code	270
Min. Negotiated Rate	$945.00
Max. Negotiated Rate	$2,160.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,350.00
Rate for Payer: Aetna Government	$1,350.00
Rate for Payer: Brighton Health Commercial	$2,025.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,836.00
Rate for Payer: Group Health Inc Commercial	$1,350.00
Rate for Payer: Group Health Inc Medicare	$945.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,350.00

ZZ LEVEEN COACC INT SET

Facility

$140.00

Hospital Charge Code	41568520
Hospital Revenue Code	270
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$112.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.00
Rate for Payer: Aetna Government	$70.00
Rate for Payer: Brighton Health Commercial	$105.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.20
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00

ZZ LEVEEN NDL ELEC 2.0/15/12

Facility

$1,550.00

Hospital Charge Code	41568530
Hospital Revenue Code	270
Min. Negotiated Rate	$542.50
Max. Negotiated Rate	$1,240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$852.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$775.00
Rate for Payer: Aetna Government	$775.00
Rate for Payer: Brighton Health Commercial	$1,162.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,054.00
Rate for Payer: Group Health Inc Commercial	$775.00
Rate for Payer: Group Health Inc Medicare	$542.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$775.00
Rate for Payer: Hamaspik Choice Inc Medicare	$775.00

ZZ LEVEEN NDL ELEC 2.0/15/15

Facility

$1,550.00

Hospital Charge Code	41568531
Hospital Revenue Code	270
Min. Negotiated Rate	$542.50
Max. Negotiated Rate	$1,240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$852.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$775.00
Rate for Payer: Aetna Government	$775.00
Rate for Payer: Brighton Health Commercial	$1,162.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,054.00
Rate for Payer: Group Health Inc Commercial	$775.00
Rate for Payer: Group Health Inc Medicare	$542.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$775.00
Rate for Payer: Hamaspik Choice Inc Medicare	$775.00

ZZ LEVEEN NDL ELEC 2.0/17/15

Facility

$1,750.00

Hospital Charge Code	41568513
Hospital Revenue Code	270
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.00
Rate for Payer: Aetna Government	$875.00
Rate for Payer: Brighton Health Commercial	$1,312.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.00
Rate for Payer: Group Health Inc Commercial	$875.00
Rate for Payer: Group Health Inc Medicare	$612.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$875.00

ZZ LEVEEN NDL ELEC 2.0/17/25

Facility

$1,750.00

Hospital Charge Code	41568514
Hospital Revenue Code	270
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.00
Rate for Payer: Aetna Government	$875.00
Rate for Payer: Brighton Health Commercial	$1,312.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.00
Rate for Payer: Group Health Inc Commercial	$875.00
Rate for Payer: Group Health Inc Medicare	$612.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$875.00

ZZ LEVEEN NDL ELEC 3.0/15/12

Facility

$1,750.00

Hospital Charge Code	41568528
Hospital Revenue Code	270
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.00
Rate for Payer: Aetna Government	$875.00
Rate for Payer: Brighton Health Commercial	$1,312.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.00
Rate for Payer: Group Health Inc Commercial	$875.00
Rate for Payer: Group Health Inc Medicare	$612.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$875.00

ZZ LEVEEN NDL ELEC 3.0/15/15

Facility

$1,750.00

Hospital Charge Code	41568529
Hospital Revenue Code	270
Min. Negotiated Rate	$612.50
Max. Negotiated Rate	$1,400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.00
Rate for Payer: Aetna Government	$875.00
Rate for Payer: Brighton Health Commercial	$1,312.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.00
Rate for Payer: Group Health Inc Commercial	$875.00
Rate for Payer: Group Health Inc Medicare	$612.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$875.00

ZZ LEVEEN NDL ELEC 3.0/17/15

Facility

$2,000.00

Hospital Charge Code	41568515
Hospital Revenue Code	270
Min. Negotiated Rate	$700.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,000.00
Rate for Payer: Aetna Government	$1,000.00
Rate for Payer: Brighton Health Commercial	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,360.00
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

ZZ LEVEEN NDL ELEC 3.0/17/25

Facility

$2,000.00

Hospital Charge Code	41568516
Hospital Revenue Code	270
Min. Negotiated Rate	$700.00
Max. Negotiated Rate	$1,600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,000.00
Rate for Payer: Aetna Government	$1,000.00
Rate for Payer: Brighton Health Commercial	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,360.00
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

ZZ LEVEEN NDL ELEC 3.5/15/12

Facility

$2,100.00

Hospital Charge Code	41568525
Hospital Revenue Code	270
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$1,680.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,155.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,050.00
Rate for Payer: Aetna Government	$1,050.00
Rate for Payer: Brighton Health Commercial	$1,575.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,680.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,428.00
Rate for Payer: Group Health Inc Commercial	$1,050.00
Rate for Payer: Group Health Inc Medicare	$735.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,050.00

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