St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ MICROCATH 3-2.3F 20 150

Facility

$489.04

Hospital Charge Code	41567350
Hospital Revenue Code	270
Min. Negotiated Rate	$171.16
Max. Negotiated Rate	$391.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$244.52
Rate for Payer: Aetna Government	$244.52
Rate for Payer: Brighton Health Commercial	$366.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$391.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$332.55
Rate for Payer: Group Health Inc Commercial	$244.52
Rate for Payer: Group Health Inc Medicare	$171.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$244.52
Rate for Payer: Hamaspik Choice Inc Medicare	$244.52

ZZ MICROCOILS

Facility

$189.24

Service Code	HCPCS C1884
Hospital Charge Code	41560057
Hospital Revenue Code	278
Min. Negotiated Rate	$94.62
Max. Negotiated Rate	$94.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.62
Rate for Payer: Hamaspik Choice Inc Medicare	$94.62

ZZ MICROCOILS

Facility

$189.24

Service Code	HCPCS C1884
Hospital Charge Code	41560057
Hospital Revenue Code	278
Min. Negotiated Rate	$66.23
Max. Negotiated Rate	$198.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$113.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$94.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.81
Rate for Payer: EmblemHealth Commercial	$94.62
Rate for Payer: Fidelis Medicare Advantage	$198.70
Rate for Payer: Group Health Inc Commercial	$94.62
Rate for Payer: Group Health Inc Medicare	$66.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.62
Rate for Payer: Hamaspik Choice Inc Medicare	$94.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$123.01

ZZ MICROCOILS 18 2/10

Facility

$189.24

Hospital Charge Code	41567158
Hospital Revenue Code	270
Min. Negotiated Rate	$66.23
Max. Negotiated Rate	$151.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$94.62
Rate for Payer: Aetna Government	$94.62
Rate for Payer: Brighton Health Commercial	$141.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$151.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.68
Rate for Payer: Group Health Inc Commercial	$94.62
Rate for Payer: Group Health Inc Medicare	$66.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.62
Rate for Payer: Hamaspik Choice Inc Medicare	$94.62

ZZ MICROCOIL TORN

Facility

$247.71

Service Code	HCPCS C1884
Hospital Charge Code	41560056
Hospital Revenue Code	278
Min. Negotiated Rate	$123.86
Max. Negotiated Rate	$123.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86

ZZ MICROCOIL TORN

Facility

$247.71

Service Code	HCPCS C1884
Hospital Charge Code	41560056
Hospital Revenue Code	278
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$260.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.07
Rate for Payer: Aetna Government	$180.07
Rate for Payer: Brighton Health Commercial	$148.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$123.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.43
Rate for Payer: EmblemHealth Commercial	$123.86
Rate for Payer: Fidelis Medicare Advantage	$260.10
Rate for Payer: Group Health Inc Commercial	$123.86
Rate for Payer: Group Health Inc Medicare	$86.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$161.01

ZZ MICROCOIL TORN 18S 3/2

Facility

$247.71

Hospital Charge Code	41567134
Hospital Revenue Code	270
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$198.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$123.86
Rate for Payer: Aetna Government	$123.86
Rate for Payer: Brighton Health Commercial	$185.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.44
Rate for Payer: Group Health Inc Commercial	$123.86
Rate for Payer: Group Health Inc Medicare	$86.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86

ZZ MICROCOIL TORN 18S 4/2

Facility

$247.71

Hospital Charge Code	41567135
Hospital Revenue Code	270
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$198.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$123.86
Rate for Payer: Aetna Government	$123.86
Rate for Payer: Brighton Health Commercial	$185.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.44
Rate for Payer: Group Health Inc Commercial	$123.86
Rate for Payer: Group Health Inc Medicare	$86.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86

ZZ MICROCOIL TORN 18S 5/2

Facility

$247.71

Hospital Charge Code	41567136
Hospital Revenue Code	270
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$198.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$123.86
Rate for Payer: Aetna Government	$123.86
Rate for Payer: Brighton Health Commercial	$185.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.44
Rate for Payer: Group Health Inc Commercial	$123.86
Rate for Payer: Group Health Inc Medicare	$86.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86

ZZ MICROCOIL TORN 18S 6/2

Facility

$247.71

Hospital Charge Code	41567137
Hospital Revenue Code	270
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$198.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$123.86
Rate for Payer: Aetna Government	$123.86
Rate for Payer: Brighton Health Commercial	$185.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.44
Rate for Payer: Group Health Inc Commercial	$123.86
Rate for Payer: Group Health Inc Medicare	$86.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.86
Rate for Payer: Hamaspik Choice Inc Medicare	$123.86

ZZ MICRO PEELAWAY SET 4.5

Facility

$124.04

Hospital Charge Code	41567042
Hospital Revenue Code	270
Min. Negotiated Rate	$43.41
Max. Negotiated Rate	$99.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.02
Rate for Payer: Aetna Government	$62.02
Rate for Payer: Brighton Health Commercial	$93.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.35
Rate for Payer: Group Health Inc Commercial	$62.02
Rate for Payer: Group Health Inc Medicare	$43.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.02
Rate for Payer: Hamaspik Choice Inc Medicare	$62.02

ZZ MICRO PEELAWAY SET 5

Facility

$124.04

Hospital Charge Code	41567043
Hospital Revenue Code	270
Min. Negotiated Rate	$43.41
Max. Negotiated Rate	$99.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.02
Rate for Payer: Aetna Government	$62.02
Rate for Payer: Brighton Health Commercial	$93.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.35
Rate for Payer: Group Health Inc Commercial	$62.02
Rate for Payer: Group Health Inc Medicare	$43.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.02
Rate for Payer: Hamaspik Choice Inc Medicare	$62.02

ZZ MICRO PEELAWAY SET 5.5

Facility

$124.04

Hospital Charge Code	41567044
Hospital Revenue Code	270
Min. Negotiated Rate	$43.41
Max. Negotiated Rate	$99.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.02
Rate for Payer: Aetna Government	$62.02
Rate for Payer: Brighton Health Commercial	$93.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.35
Rate for Payer: Group Health Inc Commercial	$62.02
Rate for Payer: Group Health Inc Medicare	$43.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.02
Rate for Payer: Hamaspik Choice Inc Medicare	$62.02

ZZ MICRO PEELAWAY SET 6

Facility

$124.04

Hospital Charge Code	41567045
Hospital Revenue Code	270
Min. Negotiated Rate	$43.41
Max. Negotiated Rate	$99.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.02
Rate for Payer: Aetna Government	$62.02
Rate for Payer: Brighton Health Commercial	$93.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.35
Rate for Payer: Group Health Inc Commercial	$62.02
Rate for Payer: Group Health Inc Medicare	$43.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.02
Rate for Payer: Hamaspik Choice Inc Medicare	$62.02

ZZ MICROPUNC KIT 4F 21G

Facility

$75.13

Hospital Charge Code	41567009
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 MICROPUNC KIT 5FR 21G

Facility

$75.13

Hospital Charge Code	41567010
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 MICROPUNCTURE 4.5F

Facility

$86.63

Hospital Charge Code	41569258
Hospital Revenue Code	270
Min. Negotiated Rate	$30.32
Max. Negotiated Rate	$69.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.32
Rate for Payer: Aetna Government	$43.32
Rate for Payer: Brighton Health Commercial	$64.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$69.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.91
Rate for Payer: Group Health Inc Commercial	$43.32
Rate for Payer: Group Health Inc Medicare	$30.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.32
Rate for Payer: Hamaspik Choice Inc Medicare	$43.32

ZZ MICROPUNCTURE 4F

Facility

$51.57

Hospital Charge Code	41569259
Hospital Revenue Code	270
Min. Negotiated Rate	$18.05
Max. Negotiated Rate	$41.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.78
Rate for Payer: Aetna Government	$25.78
Rate for Payer: Brighton Health Commercial	$38.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.07
Rate for Payer: Group Health Inc Commercial	$25.78
Rate for Payer: Group Health Inc Medicare	$18.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.78
Rate for Payer: Hamaspik Choice Inc Medicare	$25.78

ZZ MICROPUNCTURE 5.5F

Facility

$96.75

Hospital Charge Code	41569260
Hospital Revenue Code	270
Min. Negotiated Rate	$33.86
Max. Negotiated Rate	$77.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$48.38
Rate for Payer: Aetna Government	$48.38
Rate for Payer: Brighton Health Commercial	$72.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.79
Rate for Payer: Group Health Inc Commercial	$48.38
Rate for Payer: Group Health Inc Medicare	$33.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.38
Rate for Payer: Hamaspik Choice Inc Medicare	$48.38

ZZ MICROPUNCTURE 6F

Facility

$86.63

Hospital Charge Code	41569261
Hospital Revenue Code	270
Min. Negotiated Rate	$30.32
Max. Negotiated Rate	$69.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.32
Rate for Payer: Aetna Government	$43.32
Rate for Payer: Brighton Health Commercial	$64.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$69.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.91
Rate for Payer: Group Health Inc Commercial	$43.32
Rate for Payer: Group Health Inc Medicare	$30.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.32
Rate for Payer: Hamaspik Choice Inc Medicare	$43.32

ZZ MICROPUNCTURE 7F

Facility

$86.63

Hospital Charge Code	41569262
Hospital Revenue Code	270
Min. Negotiated Rate	$30.32
Max. Negotiated Rate	$69.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$43.32
Rate for Payer: Aetna Government	$43.32
Rate for Payer: Brighton Health Commercial	$64.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$69.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.91
Rate for Payer: Group Health Inc Commercial	$43.32
Rate for Payer: Group Health Inc Medicare	$30.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.32
Rate for Payer: Hamaspik Choice Inc Medicare	$43.32

ZZ MICROSHERES 100-300

Facility

$230.00

Hospital Charge Code	41569877
Hospital Revenue Code	270
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$184.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$115.00
Rate for Payer: Aetna Government	$115.00
Rate for Payer: Brighton Health Commercial	$172.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.40
Rate for Payer: Group Health Inc Commercial	$115.00
Rate for Payer: Group Health Inc Medicare	$80.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

ZZ MIK VISCERAL CATH. 5FR.038 80C

Facility

$55.10

Service Code	HCPCS C1887
Hospital Charge Code	41567742
Hospital Revenue Code	278
Min. Negotiated Rate	$27.55
Max. Negotiated Rate	$27.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.55
Rate for Payer: Hamaspik Choice Inc Medicare	$27.55

ZZ MIK VISCERAL CATH. 5FR.038 80C

Facility

$55.10

Service Code	HCPCS C1887
Hospital Charge Code	41567742
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$57.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$33.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.68
Rate for Payer: EmblemHealth Commercial	$27.55
Rate for Payer: Fidelis Medicare Advantage	$57.86
Rate for Payer: Group Health Inc Commercial	$27.55
Rate for Payer: Group Health Inc Medicare	$19.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.55
Rate for Payer: Hamaspik Choice Inc Medicare	$27.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.82

ZZ MINIMIX COOK

Facility

$220.00

Hospital Charge Code	41569965
Hospital Revenue Code	279
Min. Negotiated Rate	$77.00
Max. Negotiated Rate	$176.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$110.00
Rate for Payer: Aetna Government	$110.00
Rate for Payer: Brighton Health Commercial	$165.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$149.60
Rate for Payer: Group Health Inc Commercial	$110.00
Rate for Payer: Group Health Inc Medicare	$77.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.00
Rate for Payer: Hamaspik Choice Inc Medicare	$110.00

Know your out-of-pocket cost for care.

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