St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ SENORX 10G STERO PROBE

Facility

$400.00

Hospital Charge Code	41568806
Hospital Revenue Code	270
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$320.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$200.00
Rate for Payer: Aetna Government	$200.00
Rate for Payer: Brighton Health Commercial	$300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$320.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$272.00
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

ZZ SENORX 7G NEEDLE GUIDE

Facility

$13.00

Hospital Charge Code	41568854
Hospital Revenue Code	270
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$10.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.50
Rate for Payer: Aetna Government	$6.50
Rate for Payer: Brighton Health Commercial	$9.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.84
Rate for Payer: Group Health Inc Commercial	$6.50
Rate for Payer: Group Health Inc Medicare	$4.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6.50

ZZ SENORX 7G STERO PROBE

Facility

$400.00

Hospital Charge Code	41568807
Hospital Revenue Code	270
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$320.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$200.00
Rate for Payer: Aetna Government	$200.00
Rate for Payer: Brighton Health Commercial	$300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$320.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$272.00
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

ZZ SENORX GELMARK CLIP

Facility

$150.00

Hospital Charge Code	41568857
Hospital Revenue Code	270
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
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

ZZ SENORX M MAKER 10G

Facility

$150.00

Hospital Charge Code	41568859
Hospital Revenue Code	270
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
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

ZZ SENORXM MAKER 7G

Facility

$150.00

Hospital Charge Code	41568858
Hospital Revenue Code	270
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
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

ZZ SENORX MRI 10G BLUNT INTRO

Facility

$950.00

Hospital Charge Code	41568860
Hospital Revenue Code	270
Min. Negotiated Rate	$332.50
Max. Negotiated Rate	$760.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$522.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$475.00
Rate for Payer: Aetna Government	$475.00
Rate for Payer: Brighton Health Commercial	$712.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$760.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$646.00
Rate for Payer: Group Health Inc Commercial	$475.00
Rate for Payer: Group Health Inc Medicare	$332.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$475.00
Rate for Payer: Hamaspik Choice Inc Medicare	$475.00

ZZ SENORX MRI M CLIP

Facility

$170.00

Hospital Charge Code	41568862
Hospital Revenue Code	270
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$136.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$85.00
Rate for Payer: Aetna Government	$85.00
Rate for Payer: Brighton Health Commercial	$127.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.60
Rate for Payer: Group Health Inc Commercial	$85.00
Rate for Payer: Group Health Inc Medicare	$59.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00

ZZ SENORX MRI M TROCAR INTRO

Facility

$950.00

Hospital Charge Code	41568861
Hospital Revenue Code	270
Min. Negotiated Rate	$332.50
Max. Negotiated Rate	$760.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$522.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$475.00
Rate for Payer: Aetna Government	$475.00
Rate for Payer: Brighton Health Commercial	$712.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$760.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$646.00
Rate for Payer: Group Health Inc Commercial	$475.00
Rate for Payer: Group Health Inc Medicare	$332.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$475.00
Rate for Payer: Hamaspik Choice Inc Medicare	$475.00

ZZ SENORX MRI X CLIP

Facility

$170.00

Hospital Charge Code	41568863
Hospital Revenue Code	270
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$136.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$85.00
Rate for Payer: Aetna Government	$85.00
Rate for Payer: Brighton Health Commercial	$127.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.60
Rate for Payer: Group Health Inc Commercial	$85.00
Rate for Payer: Group Health Inc Medicare	$59.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00

ZZ SENORX RINSE TUBING

Facility

$24.80

Hospital Charge Code	41568855
Hospital Revenue Code	270
Min. Negotiated Rate	$8.68
Max. Negotiated Rate	$19.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.40
Rate for Payer: Aetna Government	$12.40
Rate for Payer: Brighton Health Commercial	$18.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.86
Rate for Payer: Group Health Inc Commercial	$12.40
Rate for Payer: Group Health Inc Medicare	$8.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.40
Rate for Payer: Hamaspik Choice Inc Medicare	$12.40

ZZ SENORX VACUUM PACKAGE

Facility

$510.00

Hospital Charge Code	41568876
Hospital Revenue Code	279
Min. Negotiated Rate	$178.50
Max. Negotiated Rate	$408.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$280.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$255.00
Rate for Payer: Aetna Government	$255.00
Rate for Payer: Brighton Health Commercial	$382.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$408.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$346.80
Rate for Payer: Group Health Inc Commercial	$255.00
Rate for Payer: Group Health Inc Medicare	$178.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$255.00
Rate for Payer: Hamaspik Choice Inc Medicare	$255.00

ZZ SFT TIP GDCATH REN LNG

Facility

$374.93

Hospital Charge Code	41567284
Hospital Revenue Code	270
Min. Negotiated Rate	$131.23
Max. Negotiated Rate	$299.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$187.46
Rate for Payer: Aetna Government	$187.46
Rate for Payer: Brighton Health Commercial	$281.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$299.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$254.95
Rate for Payer: Group Health Inc Commercial	$187.46
Rate for Payer: Group Health Inc Medicare	$131.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.46
Rate for Payer: Hamaspik Choice Inc Medicare	$187.46

ZZ SFT TIP GDCATH REN SHO

Facility

$374.93

Hospital Charge Code	41567285
Hospital Revenue Code	270
Min. Negotiated Rate	$131.23
Max. Negotiated Rate	$299.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$187.46
Rate for Payer: Aetna Government	$187.46
Rate for Payer: Brighton Health Commercial	$281.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$299.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$254.95
Rate for Payer: Group Health Inc Commercial	$187.46
Rate for Payer: Group Health Inc Medicare	$131.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.46
Rate for Payer: Hamaspik Choice Inc Medicare	$187.46

ZZ SFT TIP GUID CTH-HOCKE

Facility

$374.93

Hospital Charge Code	41567283
Hospital Revenue Code	270
Min. Negotiated Rate	$131.23
Max. Negotiated Rate	$299.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$187.46
Rate for Payer: Aetna Government	$187.46
Rate for Payer: Brighton Health Commercial	$281.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$299.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$254.95
Rate for Payer: Group Health Inc Commercial	$187.46
Rate for Payer: Group Health Inc Medicare	$131.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.46
Rate for Payer: Hamaspik Choice Inc Medicare	$187.46

ZZ SHEATH 5 FR

Facility

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567506
Hospital Revenue Code	278
Min. Negotiated Rate	$26.76
Max. Negotiated Rate	$26.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76

ZZ SHEATH 5 FR

Facility

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567506
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$56.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$32.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.77
Rate for Payer: EmblemHealth Commercial	$26.76
Rate for Payer: Fidelis Medicare Advantage	$56.19
Rate for Payer: Group Health Inc Commercial	$26.76
Rate for Payer: Group Health Inc Medicare	$18.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.78

ZZ SHEATH 5 FR.

Facility

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567515
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$56.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$32.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.77
Rate for Payer: EmblemHealth Commercial	$26.76
Rate for Payer: Fidelis Medicare Advantage	$56.19
Rate for Payer: Group Health Inc Commercial	$26.76
Rate for Payer: Group Health Inc Medicare	$18.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.78

ZZ SHEATH 5 FR.

Facility

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567515
Hospital Revenue Code	278
Min. Negotiated Rate	$26.76
Max. Negotiated Rate	$26.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76

ZZ SHEATH 5FR. 10CM.

Facility

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567503
Hospital Revenue Code	278
Min. Negotiated Rate	$26.76
Max. Negotiated Rate	$26.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76

ZZ SHEATH 5FR. 10CM.

Facility

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567503
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$56.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$32.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.77
Rate for Payer: EmblemHealth Commercial	$26.76
Rate for Payer: Fidelis Medicare Advantage	$56.19
Rate for Payer: Group Health Inc Commercial	$26.76
Rate for Payer: Group Health Inc Medicare	$18.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.78

ZZ SHEATH 5FR CATH 15-622

Facility

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567517
Hospital Revenue Code	278
Min. Negotiated Rate	$26.76
Max. Negotiated Rate	$26.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76

ZZ SHEATH 5FR CATH 15-622

Facility

$53.51

Service Code	HCPCS C1892
Hospital Charge Code	41567517
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$56.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$32.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.77
Rate for Payer: EmblemHealth Commercial	$26.76
Rate for Payer: Fidelis Medicare Advantage	$56.19
Rate for Payer: Group Health Inc Commercial	$26.76
Rate for Payer: Group Health Inc Medicare	$18.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.78

ZZ SHEATH 7 25 38

Facility

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567062
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$113.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$64.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.94
Rate for Payer: EmblemHealth Commercial	$53.86
Rate for Payer: Fidelis Medicare Advantage	$113.12
Rate for Payer: Group Health Inc Commercial	$53.86
Rate for Payer: Group Health Inc Medicare	$37.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.02

ZZ SHEATH 7 25 38

Facility

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567062
Hospital Revenue Code	278
Min. Negotiated Rate	$53.86
Max. Negotiated Rate	$53.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86

Know your out-of-pocket cost for care.

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