St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ LUMINEX STENT 7X60

Facility

$5,103.00

Service Code	HCPCS C1876
Hospital Charge Code	41569653
Hospital Revenue Code	278
Min. Negotiated Rate	$2,551.50
Max. Negotiated Rate	$2,551.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,551.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,551.50

ZZ LUMINEX STENT 7X60 6F

Facility

$4,521.83

Service Code	HCPCS C1876
Hospital Charge Code	41569755
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,747.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,487.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,713.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,260.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,600.05
Rate for Payer: EmblemHealth Commercial	$2,260.92
Rate for Payer: Fidelis Medicare Advantage	$4,747.92
Rate for Payer: Group Health Inc Commercial	$2,260.92
Rate for Payer: Group Health Inc Medicare	$1,582.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,260.92
Rate for Payer: Hamaspik Choice Inc Medicare	$2,260.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,939.19

ZZ LUMINEX STENT 7X60 6F

Facility

$4,521.83

Service Code	HCPCS C1876
Hospital Charge Code	41569755
Hospital Revenue Code	278
Min. Negotiated Rate	$2,260.92
Max. Negotiated Rate	$2,260.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,260.92
Rate for Payer: Hamaspik Choice Inc Medicare	$2,260.92

ZZ LUMINEX STENT 8X50

Facility

$4,252.50

Service Code	HCPCS C1876
Hospital Charge Code	41569657
Hospital Revenue Code	278
Min. Negotiated Rate	$2,126.25
Max. Negotiated Rate	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,126.25

ZZ LUMINEX STENT 8X50

Facility

$4,252.50

Service Code	HCPCS C1876
Hospital Charge Code	41569657
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,465.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,338.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,551.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,126.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,445.19
Rate for Payer: EmblemHealth Commercial	$2,126.25
Rate for Payer: Fidelis Medicare Advantage	$4,465.12
Rate for Payer: Group Health Inc Commercial	$2,126.25
Rate for Payer: Group Health Inc Medicare	$1,488.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,126.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,126.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,764.12

ZZ LUMINEX STENT 8X50 6F

Facility

$4,394.25

Service Code	HCPCS C1876
Hospital Charge Code	41569759
Hospital Revenue Code	278
Min. Negotiated Rate	$2,197.12
Max. Negotiated Rate	$2,197.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,197.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,197.12

ZZ LUMINEX STENT 8X50 6F

Facility

$4,394.25

Service Code	HCPCS C1876
Hospital Charge Code	41569759
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,613.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,416.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,636.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,197.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,526.69
Rate for Payer: EmblemHealth Commercial	$2,197.12
Rate for Payer: Fidelis Medicare Advantage	$4,613.96
Rate for Payer: Group Health Inc Commercial	$2,197.12
Rate for Payer: Group Health Inc Medicare	$1,537.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,197.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,197.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,856.26

ZZ LUMINEX STENT 8X60 6F

Facility

$4,521.83

Service Code	HCPCS C1876
Hospital Charge Code	41569758
Hospital Revenue Code	278
Min. Negotiated Rate	$2,260.92
Max. Negotiated Rate	$2,260.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,260.92
Rate for Payer: Hamaspik Choice Inc Medicare	$2,260.92

ZZ LUMINEX STENT 8X60 6F

Facility

$4,521.83

Service Code	HCPCS C1876
Hospital Charge Code	41569758
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,747.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,487.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,713.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,260.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,600.05
Rate for Payer: EmblemHealth Commercial	$2,260.92
Rate for Payer: Fidelis Medicare Advantage	$4,747.92
Rate for Payer: Group Health Inc Commercial	$2,260.92
Rate for Payer: Group Health Inc Medicare	$1,582.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,260.92
Rate for Payer: Hamaspik Choice Inc Medicare	$2,260.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,939.19

ZZ LUMINEX STENT L7 X 40 6F

Facility

$4,394.25

Service Code	HCPCS C1876
Hospital Charge Code	41569757
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$4,613.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,416.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,636.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,197.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,526.69
Rate for Payer: EmblemHealth Commercial	$2,197.12
Rate for Payer: Fidelis Medicare Advantage	$4,613.96
Rate for Payer: Group Health Inc Commercial	$2,197.12
Rate for Payer: Group Health Inc Medicare	$1,537.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,197.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,197.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,856.26

ZZ LUMINEX STENT L7 X 40 6F

Facility

$4,394.25

Service Code	HCPCS C1876
Hospital Charge Code	41569757
Hospital Revenue Code	278
Min. Negotiated Rate	$2,197.12
Max. Negotiated Rate	$2,197.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,197.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2,197.12

ZZ MAGNEVIST 15ML

Facility

$84.44

Hospital Charge Code	41568411
Hospital Revenue Code	270
Min. Negotiated Rate	$29.55
Max. Negotiated Rate	$67.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$42.22
Rate for Payer: Aetna Government	$42.22
Rate for Payer: Brighton Health Commercial	$63.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$57.42
Rate for Payer: Group Health Inc Commercial	$42.22
Rate for Payer: Group Health Inc Medicare	$29.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.22
Rate for Payer: Hamaspik Choice Inc Medicare	$42.22

ZZ MAGNEVIST 20ML

Facility

$112.58

Hospital Charge Code	41568412
Hospital Revenue Code	270
Min. Negotiated Rate	$39.40
Max. Negotiated Rate	$90.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.29
Rate for Payer: Aetna Government	$56.29
Rate for Payer: Brighton Health Commercial	$84.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.55
Rate for Payer: Group Health Inc Commercial	$56.29
Rate for Payer: Group Health Inc Medicare	$39.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.29
Rate for Payer: Hamaspik Choice Inc Medicare	$56.29

ZZ MAHURKAR QPLUS 13.5FR X 16CM

Facility

$847.46

Service Code	HCPCS C1725
Hospital Charge Code	41569874
Hospital Revenue Code	278
Min. Negotiated Rate	$423.73
Max. Negotiated Rate	$423.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.73
Rate for Payer: Hamaspik Choice Inc Medicare	$423.73

ZZ MAHURKAR QPLUS 13.5FR X 16CM

Facility

$847.46

Service Code	HCPCS C1725
Hospital Charge Code	41569874
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$889.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$466.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$508.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$423.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$487.29
Rate for Payer: EmblemHealth Commercial	$423.73
Rate for Payer: Fidelis Medicare Advantage	$889.83
Rate for Payer: Group Health Inc Commercial	$423.73
Rate for Payer: Group Health Inc Medicare	$296.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.73
Rate for Payer: Hamaspik Choice Inc Medicare	$423.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$550.85

ZZ MAHURKAR QPLUS 13.5FR X 19.5CM

Facility

$847.46

Service Code	HCPCS C1725
Hospital Charge Code	41569875
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$889.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$466.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$508.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$423.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$487.29
Rate for Payer: EmblemHealth Commercial	$423.73
Rate for Payer: Fidelis Medicare Advantage	$889.83
Rate for Payer: Group Health Inc Commercial	$423.73
Rate for Payer: Group Health Inc Medicare	$296.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.73
Rate for Payer: Hamaspik Choice Inc Medicare	$423.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$550.85

ZZ MAHURKAR QPLUS 13.5FR X 19.5CM

Facility

$847.46

Service Code	HCPCS C1725
Hospital Charge Code	41569875
Hospital Revenue Code	278
Min. Negotiated Rate	$423.73
Max. Negotiated Rate	$423.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.73
Rate for Payer: Hamaspik Choice Inc Medicare	$423.73

ZZ MAHURKAR QPLUS 13.5FR X 24CM

Facility

$880.89

Service Code	HCPCS C1725
Hospital Charge Code	41569876
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$924.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$484.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$528.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$440.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$506.51
Rate for Payer: EmblemHealth Commercial	$440.44
Rate for Payer: Fidelis Medicare Advantage	$924.93
Rate for Payer: Group Health Inc Commercial	$440.44
Rate for Payer: Group Health Inc Medicare	$308.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$440.44
Rate for Payer: Hamaspik Choice Inc Medicare	$440.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$572.58

ZZ MAHURKAR QPLUS 13.5FR X 24CM

Facility

$880.89

Service Code	HCPCS C1725
Hospital Charge Code	41569876
Hospital Revenue Code	278
Min. Negotiated Rate	$440.44
Max. Negotiated Rate	$440.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$440.44
Rate for Payer: Hamaspik Choice Inc Medicare	$440.44

ZZ MAHURTR CATH 11.5 19.5

Facility

$234.60

Hospital Charge Code	41567280
Hospital Revenue Code	270
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$187.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$117.30
Rate for Payer: Aetna Government	$117.30
Rate for Payer: Brighton Health Commercial	$175.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$187.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.53
Rate for Payer: Group Health Inc Commercial	$117.30
Rate for Payer: Group Health Inc Medicare	$82.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.30
Rate for Payer: Hamaspik Choice Inc Medicare	$117.30

ZZ MAHURTR CATHKIT 11.5 13

Facility

$234.60

Hospital Charge Code	41567281
Hospital Revenue Code	270
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$187.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$117.30
Rate for Payer: Aetna Government	$117.30
Rate for Payer: Brighton Health Commercial	$175.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$187.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.53
Rate for Payer: Group Health Inc Commercial	$117.30
Rate for Payer: Group Health Inc Medicare	$82.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.30
Rate for Payer: Hamaspik Choice Inc Medicare	$117.30

ZZ MAHURTR CATHKIT 11.5 16

Facility

$234.60

Hospital Charge Code	41567282
Hospital Revenue Code	270
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$187.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$117.30
Rate for Payer: Aetna Government	$117.30
Rate for Payer: Brighton Health Commercial	$175.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$187.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.53
Rate for Payer: Group Health Inc Commercial	$117.30
Rate for Payer: Group Health Inc Medicare	$82.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.30
Rate for Payer: Hamaspik Choice Inc Medicare	$117.30

ZZ MALLINCKRODT TAD 2 WIRE

Facility

$255.15

Hospital Charge Code	41569631
Hospital Revenue Code	270
Min. Negotiated Rate	$89.30
Max. Negotiated Rate	$204.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$140.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$127.58
Rate for Payer: Aetna Government	$127.58
Rate for Payer: Brighton Health Commercial	$191.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.50
Rate for Payer: Group Health Inc Commercial	$127.58
Rate for Payer: Group Health Inc Medicare	$89.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$127.58
Rate for Payer: Hamaspik Choice Inc Medicare	$127.58

ZZ MANIFOLD/LEET

Facility

$41.46

Hospital Charge Code	41569255
Hospital Revenue Code	270
Min. Negotiated Rate	$14.51
Max. Negotiated Rate	$33.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.73
Rate for Payer: Aetna Government	$20.73
Rate for Payer: Brighton Health Commercial	$31.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.19
Rate for Payer: Group Health Inc Commercial	$20.73
Rate for Payer: Group Health Inc Medicare	$14.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.73
Rate for Payer: Hamaspik Choice Inc Medicare	$20.73

ZZ MANIFOLD PERC HIG PRE

Facility

$65.21

Hospital Charge Code	41567309
Hospital Revenue Code	270
Min. Negotiated Rate	$22.82
Max. Negotiated Rate	$52.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.60
Rate for Payer: Aetna Government	$32.60
Rate for Payer: Brighton Health Commercial	$48.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.34
Rate for Payer: Group Health Inc Commercial	$32.60
Rate for Payer: Group Health Inc Medicare	$22.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.60
Rate for Payer: Hamaspik Choice Inc Medicare	$32.60

Know your out-of-pocket cost for care.

All Charges