St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ MM RESOLVE CATHETER

Facility

$120.00

Hospital Charge Code	41561355
Hospital Revenue Code	272
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$96.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.00
Rate for Payer: Aetna Government	$60.00
Rate for Payer: Brighton Health Commercial	$90.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$96.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.60
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00

ZZ MONTE - 1, PULM CATH

Facility

$50.67

Hospital Charge Code	41567504
Hospital Revenue Code	270
Min. Negotiated Rate	$17.73
Max. Negotiated Rate	$40.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.34
Rate for Payer: Aetna Government	$25.34
Rate for Payer: Brighton Health Commercial	$38.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.46
Rate for Payer: Group Health Inc Commercial	$25.34
Rate for Payer: Group Health Inc Medicare	$17.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.34
Rate for Payer: Hamaspik Choice Inc Medicare	$25.34

ZZ MONTEFIORE SPEC CATH

Facility

$50.67

Hospital Charge Code	41567187
Hospital Revenue Code	270
Min. Negotiated Rate	$17.73
Max. Negotiated Rate	$40.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.34
Rate for Payer: Aetna Government	$25.34
Rate for Payer: Brighton Health Commercial	$38.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.46
Rate for Payer: Group Health Inc Commercial	$25.34
Rate for Payer: Group Health Inc Medicare	$17.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.34
Rate for Payer: Hamaspik Choice Inc Medicare	$25.34

ZZ MOTOR DRIVE

Facility

$322.83

Hospital Charge Code	41567197
Hospital Revenue Code	270
Min. Negotiated Rate	$112.99
Max. Negotiated Rate	$258.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$177.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$161.42
Rate for Payer: Aetna Government	$161.42
Rate for Payer: Brighton Health Commercial	$242.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$258.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$219.52
Rate for Payer: Group Health Inc Commercial	$161.42
Rate for Payer: Group Health Inc Medicare	$112.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.42
Rate for Payer: Hamaspik Choice Inc Medicare	$161.42

ZZ MULTI ANGLE REPLACEMENT KIT

Facility

$1,009.97

Hospital Charge Code	41569034
Hospital Revenue Code	270
Min. Negotiated Rate	$353.49
Max. Negotiated Rate	$807.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$555.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$504.98
Rate for Payer: Aetna Government	$504.98
Rate for Payer: Brighton Health Commercial	$757.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$807.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$686.78
Rate for Payer: Group Health Inc Commercial	$504.98
Rate for Payer: Group Health Inc Medicare	$353.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$504.98
Rate for Payer: Hamaspik Choice Inc Medicare	$504.98

ZZ MULTI TORQUE VISE

Facility

$19.49

Hospital Charge Code	41567307
Hospital Revenue Code	270
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$15.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.74
Rate for Payer: Aetna Government	$9.74
Rate for Payer: Brighton Health Commercial	$14.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.25
Rate for Payer: Group Health Inc Commercial	$9.74
Rate for Payer: Group Health Inc Medicare	$6.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.74
Rate for Payer: Hamaspik Choice Inc Medicare	$9.74

ZZ MUSTANG PTA

Facility

$500.00

Hospital Charge Code	66520351
Hospital Revenue Code	270
Min. Negotiated Rate	$175.00
Max. Negotiated Rate	$400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$250.00
Rate for Payer: Aetna Government	$250.00
Rate for Payer: Brighton Health Commercial	$375.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$340.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

ZZ MYNX 5F

Facility

$460.00

Service Code	HCPCS C1760
Hospital Charge Code	41567746
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$483.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.50
Rate for Payer: Aetna Government	$73.50
Rate for Payer: Brighton Health Commercial	$276.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$264.50
Rate for Payer: EmblemHealth Commercial	$230.00
Rate for Payer: Fidelis Medicare Advantage	$483.00
Rate for Payer: Group Health Inc Commercial	$230.00
Rate for Payer: Group Health Inc Medicare	$161.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$299.00

ZZ MYNX 5F

Facility

$460.00

Service Code	HCPCS C1760
Hospital Charge Code	41567746
Hospital Revenue Code	278
Min. Negotiated Rate	$230.00
Max. Negotiated Rate	$230.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00

ZZ MYNX 6F/7F

Facility

$400.00

Service Code	HCPCS C1760
Hospital Charge Code	41567745
Hospital Revenue Code	278
Min. Negotiated Rate	$200.00
Max. Negotiated Rate	$200.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00

ZZ MYNX 6F/7F

Facility

$400.00

Service Code	HCPCS C1760
Hospital Charge Code	41567745
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$420.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.50
Rate for Payer: Aetna Government	$73.50
Rate for Payer: Brighton Health Commercial	$240.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.00
Rate for Payer: EmblemHealth Commercial	$200.00
Rate for Payer: Fidelis Medicare Advantage	$420.00
Rate for Payer: Group Health Inc Commercial	$200.00
Rate for Payer: Group Health Inc Medicare	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.00

ZZ NAVILYST EXODUS DRAIN CATH

Facility

$150.00

Service Code	HCPCS C1729
Hospital Charge Code	41563106
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

ZZ NAVILYST EXODUS DRAIN CATH

Facility

$150.00

Service Code	HCPCS C1729
Hospital Charge Code	41563106
Hospital Revenue Code	278
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$157.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.42
Rate for Payer: Aetna Government	$2.42
Rate for Payer: Brighton Health Commercial	$90.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.25
Rate for Payer: EmblemHealth Commercial	$75.00
Rate for Payer: Fidelis Medicare Advantage	$157.50
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$97.50

ZZ NDL BSD 18VT 7 18 1 WAL

Facility

$8.51

Hospital Charge Code	41567011
Hospital Revenue Code	270
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$6.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.26
Rate for Payer: Aetna Government	$4.26
Rate for Payer: Brighton Health Commercial	$6.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.79
Rate for Payer: Group Health Inc Commercial	$4.26
Rate for Payer: Group Health Inc Medicare	$2.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.26
Rate for Payer: Hamaspik Choice Inc Medicare	$4.26

ZZ NDL BSD 19VT 7 19 1 WAL

Facility

$8.51

Hospital Charge Code	41567012
Hospital Revenue Code	270
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$6.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.26
Rate for Payer: Aetna Government	$4.26
Rate for Payer: Brighton Health Commercial	$6.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.79
Rate for Payer: Group Health Inc Commercial	$4.26
Rate for Payer: Group Health Inc Medicare	$2.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.26
Rate for Payer: Hamaspik Choice Inc Medicare	$4.26

ZZ NDL DCM 19VT 7 19 2 WALL

Facility

$13.82

Hospital Charge Code	41567013
Hospital Revenue Code	270
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$11.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.91
Rate for Payer: Aetna Government	$6.91
Rate for Payer: Brighton Health Commercial	$10.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.40
Rate for Payer: Group Health Inc Commercial	$6.91
Rate for Payer: Group Health Inc Medicare	$4.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.91
Rate for Payer: Hamaspik Choice Inc Medicare	$6.91

ZZ NEEDLE/18G/20CM

Facility

$19.60

Hospital Charge Code	41569263
Hospital Revenue Code	270
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$15.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.80
Rate for Payer: Aetna Government	$9.80
Rate for Payer: Brighton Health Commercial	$14.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.33
Rate for Payer: Group Health Inc Commercial	$9.80
Rate for Payer: Group Health Inc Medicare	$6.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.80
Rate for Payer: Hamaspik Choice Inc Medicare	$9.80

ZZ NEEDLE/18G SINGLE WALL/18G/9CM

Facility

$4.63

Hospital Charge Code	41569264
Hospital Revenue Code	270
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$3.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.32
Rate for Payer: Aetna Government	$2.32
Rate for Payer: Brighton Health Commercial	$3.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.15
Rate for Payer: Group Health Inc Commercial	$2.32
Rate for Payer: Group Health Inc Medicare	$1.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.32
Rate for Payer: Hamaspik Choice Inc Medicare	$2.32

ZZ NEEDLE/21G SINGLE WALL/21G/7CM

Facility

$5.31

Hospital Charge Code	41569266
Hospital Revenue Code	270
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$4.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.66
Rate for Payer: Aetna Government	$2.66
Rate for Payer: Brighton Health Commercial	$3.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.61
Rate for Payer: Group Health Inc Commercial	$2.66
Rate for Payer: Group Health Inc Medicare	$1.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.66
Rate for Payer: Hamaspik Choice Inc Medicare	$2.66

ZZ NEEDLE/21G TROCAR/21G/15CM

Facility

$19.60

Hospital Charge Code	41569267
Hospital Revenue Code	270
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$15.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.80
Rate for Payer: Aetna Government	$9.80
Rate for Payer: Brighton Health Commercial	$14.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.33
Rate for Payer: Group Health Inc Commercial	$9.80
Rate for Payer: Group Health Inc Medicare	$6.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.80
Rate for Payer: Hamaspik Choice Inc Medicare	$9.80

ZZ NEEDLE/21G TROCAR/21G/20CM

Facility

$19.60

Hospital Charge Code	41569268
Hospital Revenue Code	270
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$15.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.80
Rate for Payer: Aetna Government	$9.80
Rate for Payer: Brighton Health Commercial	$14.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.33
Rate for Payer: Group Health Inc Commercial	$9.80
Rate for Payer: Group Health Inc Medicare	$6.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.80
Rate for Payer: Hamaspik Choice Inc Medicare	$9.80

ZZ NEEDLE CHIBA 18G 10CM

Facility

$34.50

Hospital Charge Code	41569894
Hospital Revenue Code	270
Min. Negotiated Rate	$12.08
Max. Negotiated Rate	$27.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.25
Rate for Payer: Aetna Government	$17.25
Rate for Payer: Brighton Health Commercial	$25.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.46
Rate for Payer: Group Health Inc Commercial	$17.25
Rate for Payer: Group Health Inc Medicare	$12.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.25
Rate for Payer: Hamaspik Choice Inc Medicare	$17.25

ZZ NEEDLE CHIBA 18G 15CM

Facility

$26.00

Hospital Charge Code	41569895
Hospital Revenue Code	270
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$20.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.00
Rate for Payer: Aetna Government	$13.00
Rate for Payer: Brighton Health Commercial	$19.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.68
Rate for Payer: Group Health Inc Commercial	$13.00
Rate for Payer: Group Health Inc Medicare	$9.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.00
Rate for Payer: Hamaspik Choice Inc Medicare	$13.00

ZZ NEEDLE CHIBA 18G 20CM

Facility

$26.00

Hospital Charge Code	41569896
Hospital Revenue Code	270
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$20.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.00
Rate for Payer: Aetna Government	$13.00
Rate for Payer: Brighton Health Commercial	$19.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.68
Rate for Payer: Group Health Inc Commercial	$13.00
Rate for Payer: Group Health Inc Medicare	$9.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.00
Rate for Payer: Hamaspik Choice Inc Medicare	$13.00

ZZ NEEDLE/FRANSEEN/22G/10CM

Facility

$56.00

Hospital Charge Code	41569711
Hospital Revenue Code	270
Min. Negotiated Rate	$19.60
Max. Negotiated Rate	$44.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.00
Rate for Payer: Aetna Government	$28.00
Rate for Payer: Brighton Health Commercial	$42.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.08
Rate for Payer: Group Health Inc Commercial	$28.00
Rate for Payer: Group Health Inc Medicare	$19.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.00
Rate for Payer: Hamaspik Choice Inc Medicare	$28.00

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